Cruciate Ligament Reconstruction Using LARS Artificial Ligament With Finite Element Method And Clinical Application Study

Objective To explore whether the angle of the femoral tunnel has effect on thefemoral tunnel enlargement and find the best femoral tunnel with the aim of minimizingbone tunnel enlargement after anterior cruciate ligament (ACL) reconstruction.Methods Based on the MRI images, the3D finite element models of knee joint andbone tunnels were constructed, and then the loading calculation and analysis of result werecarried out.Results The contact pressures in the femoral tunnel walls which were10°and40°relative to the midcoronal plane were significantly higher than those of other femoral tunnelmodels. With respect to the femoral tunnel which were25°and20°relative to the midcoronalplane, the difference of the contact pressure in the anterior wall was not significant, while thecontact pressure in the posterior wall of the later was higher than that of the former.Concerning the femoral tunnel models which were25°and30°relative to the midcoronalplane, the difference of the contact pressure in the posterior wall was not significant, while thecontact pressure in the anterior wall of the later was higher than that of the former.Conclusion The femoral tunnel angle had much effect on the contact pressure in thefemoral tunnel which could lead to femoral tunnel enlargement and the25°femoral tunnel isthe best femoral tunnel minimizing the femoral tunnel enlargement after ACL reconstruction. Background The aims of this study were to analyze the operating methods andfundmental clinical effects of reconstruction of anterior cruciate ligament (ACL) withthe ligament advancement reinforcement system (LARS) artificial ligaments underarthroscope.Methods Since June of2006,53patients（37males and16females, with an averageage of36.4years）with ACL rupture were treated with the LARS artificial ligaments. Theresults of preoperative MRI of all patients suggested discontinuation of ACL. The score ofLysholm on knee joint was53.1±8.9points. The operations were completed underarthroscope. Bone tunnels of the femur were located at the central point of arc on themedial surface of ectocondyle of140degree. With respect to the femoral axis is25°angleneedle. Bone tunnels of tibia were located between the medial and lateral condyle on thetibial plateau2-4mm to summit line of fossa intercondylica.Results All53patients were available for follow-up with an average of45mo(36-52mo). After3years of the operation， the Lysholm’s was93.2±3.4points. The finalIKDC score3y postoperation were rated as normal in29patients(55%), nearly normal in23patients(43%), abnormal in two patients(2%), The excellent and good rate was98%. Nopostoperative complications such as infection, ligament rupture, ligament cinch occurred.Conclusions The anatomical reconstruction and the stability of the knee joint can beobtained after ACL reconstruction with LARS artificial ligaments. The operation underarthroscope has advantages of micro-injury, rapid recovery and satisfactory curative effect. Objective This study aims to analyze the operative and preliminary clinical effectsof arthroscopic reconstruction of posterior cruciate ligament (PCL) using LigamentAdvanced Reinforcement System (LARS). Methods From June2006,41patients (25males and16females, with an averageage of33.6years) with PCL ruptures were treated with LARS ligament using anarthroscopy. The preoperative MRI of all patients revealed rupture of PCL. Thepreoperative Lysholm score was64.9±8.8points. The tibial isometric point and tunnelwere drilled with the help of a drill bit guide, while the femoral isometric point and tunnelwere drilled under the observation of a C-arm.Results All patients were regularly followed up for an average period of44months（range,36-54mo）. The postoperative Lysholm score was92.1±3.3points. The finalIKDC score3y postoperation were rated as normal in21patients(51%), nearly normal in17patients(42%), abnormal in3patients(7%), The excellent and good rate was93%.Complications such as infection, spontaneous rupture or laxity of graft was not observed.Conclusions Posterior cruciate ligament reconstruction with the use of LARSartificial ligaments leads to good anatomic reconstruction and knee function. Thearthroscopic reconstructions have features such as micro-injury, rapid recovery andsatisfactory clinical effect. Objective The aims of this study were to explore the operating methods andfundamental clinical effects of reconstruction of anterior and posterior cruciate ligament(ACL and PCL) with the ligament advancement reinforcement system (LARS) artificialligaments under arthroscope.Methods Since June of2006,21patients（13males and8females, with an averageage of31.5years）with ACL and PCL rupture were treated with the LARS artificialligaments. The results of preoperative MRI of all patients suggested discontinuation ofACL and PCL. The score of Lysholm on knee joint was47.6±6.7points. The operationswere completed under arthroscope. The posterior cruciate ligament was first reconstruction,and the anterior cruciate ligment was followed.Results: All21patients were available for follow-up with an average period of 42mo(range,36-49mo). No postoperative complications such as infection, ligamentrupture, ligament cinch occurred. The final Lysholm’s score at3y postoperatively was90.8±3.7points. The clinical results were graded as normal in14patients, near normal in6and abnormal in1, according to the IKDC knee evaluation score. The excellent and goodrate was95%.Conclusions: The anatomical reconstruction and the stability of the knee joint can beobtained after ACL and PCL reconstruction with LARS artificial ligaments using anarthroscopy. The operation under arthroscope has advantages of micro-injury, rapidrecovery and satisfactory curative effect.