| Objective: This retrospective study compared the results after anterior cruciate ligament(ACL)reconstruction using the Ligament Advanced Reinforcement System(LARS)versus a four-strand hamstring tendon graft with a minimum follow-up of 7 years,and analyzed in detail the advantages and disadvantages of them.The comparison and analysis had been made between the young patients(18 to 20 years old)who used LARS artificial ligament and the ones who used four-strand hamstring tendon autograft for knee joint reconstruction,and the postoperative complications of the two grafts were studied thoroughly and systematically.Process: From March 2004 to December 2008,62 cases of knee joint anterior cruciate ligament injury,underwent reconstruction with four-strand autologous hamstring tendon and LARS artificial ligament as a graft,respectively.Among these patients,21 cases with an average age of24.6(18-39)were treated with LARS artificial ligament,17 men and 4 women,and the course is from 5 days to 10 months,the average time of injury 3.2 months,the average follow-up 9.4 years(7-11 years).41 cases with an average age of 33.3(18-59)were treated with hamstring tendon autograft,26 men and 15 women,and the course is from 3 days to 11 months,the average time of injury 3.7 months,the average follow-up 8.7 years(7-11 years).In addition,this study selected the survey results of the LARS artificial ligament group for regrouping,with the patients less than 20 years old(18-20)in the LARS ligament group marked as 1 group,a total of 9 cases,8 men 1 woman;the patients less than 20 years old(18-20)in the hamstring tendon autograft group marked as group 2,a total of 7 cases,2 men and 5 women.Evaluation criteria: the subjective assessment includes the Lysholm scoring system,International Knee Documentation Committee table(IKDC 2000),Tegner scoring(see table 1-3),etc.and the objective assessment includes kt-2000 knee joint mobility instrument examination.Results: We can draw the following conclusions through the Lysholm scale,Tegner ratings and IKDC scores: there is no significant difference between the LARS group and the four-strand hamstring tendon autograft group for the patients with the arthroscopic anterior cruciate ligament reconstruction during the 7 years of follow-up after surgery.54 patients obtained good stability after surgery in 62 patients,with tibial anterior translation occurred between 3-5mm relative to the normal side in 4 patients,2 patients in each group;tibial anterior translation occurred more than 5mm relative to the normal side in the other 4 patients,2 patients in each group.2 patients in the LARS ligament group had the secondary revision surgery due to the complete or partial ligament rupture,and in addition,tibial anterior translation occurred more than 5mm relative to the normal side in the other two patients.There was no statistically significant difference between the LARS group(18 to 20 years old)and the four-strand hamstring tendon autograft group according to the Lysholm scale,Tegner ratings and IKDC scores.Tibial anterior translation occurred between 3-5 mm relative to the normal side in 1 patient in each group,and graft fracture is not found in two groups.Conclusion: At a minimum follow-up of 7 years,the subjective scores and objective evaluation for the LARS artificial ligament group and the hamstring tendon autograft group are satisfactory without significant difference after the surgery during the average follow-up of 9.4 years for the LARS ligament group.And also there is no obvious difference for the young patients(18 to 20 years old)in the two groups according to the Lysholm scale,Tegner ratings and IKDC scores.No severe complications such as infection,synovitis were found in the LARS artificial ligament group during the average follow-up of 9.4 years.The period of recovery is shorter for the young patients in the LARS ligament group,and they can take part in physicalexercise faster after the surgery,which is more acceptable for the patients. |
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