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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 11/2019

01-11-2019 | KNEE

Primary ACL reconstruction using the LARS device is associated with a high failure rate at minimum of 6-year follow-up

Authors: Scott John Tulloch, Brian Meldan Devitt, Tabitha Porter, Taylor Hartwig, Haydn Klemm, Sam Hookway, Cameron John Norsworthy

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 11/2019

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Abstract

Purpose

The Ligament Augmentation and Reconstruction System (LARS®) is a synthetic ligament consisting of fibres made of polyethylene terephthalate. Despite the LARS being used as an anterior cruciate ligament (ACL) device for nearly 30 years and the well-documented complications from earlier synthetic ligament designs, there is a paucity of published medium- to long-term results. The aim of this study is to report the clinical and functional outcomes after ACL reconstruction using the LARS at a minimum follow-up of 6 years.

Methods

Results of a single surgeon’s entire cohort of 55 patients who underwent primary LARS ACL surgery were reviewed at a median of 7.8 years (6.0–9.4). Patient-reported outcome measures including the International Knee Documentation Committee (IKDC) score and 36-Item Short Form Health Survey (SF-36) were collected and clinical assessment consisted of range of motion (ROM) and the KT-1000 arthrometer to assess the side–side difference in the operative and non-operative knee. Mechanical failures of the graft were confirmed at revision surgery and a survivorship analysis was performed using the Kaplan–Meier method.

Results

The overall mechanical failure rate was 17/51 (33.3%) with ruptures occurring at a median 3.9 years (0.6–8.8 years) following primary LARS ACL surgery. Secondary operative procedures were performed in 39.2% of patients. For intact grafts, there was no statistically significant difference is side-to-side ROM or anterior knee laxity and subjective scores revealed a median IKDC subjective score of 85.1 (26.4–100) and SF-36 physical component score of 94.1.

Conclusion

The rates of LARS ACL construct failure (33.3%) in this cohort are high and based on these results the LARS should not be considered as a graft option for primary ACL reconstruction.

Level of evidence

III, cohort study.
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Metadata
Title
Primary ACL reconstruction using the LARS device is associated with a high failure rate at minimum of 6-year follow-up
Authors
Scott John Tulloch
Brian Meldan Devitt
Tabitha Porter
Taylor Hartwig
Haydn Klemm
Sam Hookway
Cameron John Norsworthy
Publication date
01-11-2019
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 11/2019
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-019-05478-3

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