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Midterm Clinical Outcomes and Knee Stability After ACL Reconstruction With a Hybrid Graft Using Hamstring Autograft and Ligament Augmentation and Reconstruction System LARS

Midterm Clinical Outcomes and Knee Stability After ACL Reconstruction With a Hybrid Graft Using Hamstring Autograft and Ligament Augmentation and Reconstruction System LARS

Antonios T. Kouzelis, MD, PhD, GREECE Andreas Panagopoulos, Associate Professor, GREECE Panagiotis Antzoulas, MD, MSc, GREECE Panagiotis Tsiplakos, MD, GREECE Georgios Sinos, MD, GREECE Spyridon Papagiannis, MD, GREECE Ioannis Gliatis, MD, PhD, Assistant Proffessor, GREECE

Orthopaedic clinic, University Hospital of Patras, PATRAS, GREECE


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Anatomic Location

Anatomic Structure

Diagnosis / Condition

Ligaments

ACL

Diagnosis Method


Summary: The purpose of this study is to analyze the midterm clinical results after ACL reconstruction with a hybrid graft using a hamstring autograft and a Ligament Augmentation and Reconstruction System (LARS).


PURPOSE:The purpose of this study is to analyze the midterm clinical results after ACL reconstruction with a hybrid graft using a hamstring autograft and a Ligament Augmentation and Reconstruction System (LARS).

Method

A retrospective study which included 82 patients (54 male:28 female, mean age of 36,4years,ranging between 15-58 years old) who underwent ACL reconstruction using a hybrid graft (hamstring autograft and LARS) from 2010 to 2019.The main indication for the amplification was the small diameter of the autograft (< 7.5 mm) even when using a 5-strand graft. The femoral fixation (medial portal) was achieved by an osseous button and the tibial fixation by a sheath-screw system and staple. Postoperatively the patients followed an accelerated physiotherapy rehabilitation protocol and the clinical results were evaluated on last follow-up visit ,at least 2 years post-op, using the IKDC, Lysholm and Tegner score and the anterior-posterior stability of the knee was measured by the use of a KT-1000 arthometer.

Results

The mean follow-up was 4.3 years (2.2 – 8.2 years) . The mean diameter of the autograft was measured at 7.11±0.68 and was amplified to 8.76±0.56 after the addition of the LARS. Anterior-Posterior translation with the use of the KT-1000 arthometer ,in comparison to the contralateral healthy knee, ranged between 1to 5mm (mean2.4±1.98 mm). Preoperatively the mean scores of the IKDC, Lysholm and Tegner were 67.88±11.39, 79.32±11.45 and 3.88±1.26 and improved ,when evaluated during the last re-examination, to 94±11.44, 95.46±5.03 and 7.33±1.37 respectively. One ACL graft rupture was reported. There were no cases of infection reported. Two patients complained of pain at the staple site.

Conclusions

The use of LARS as a graft amplifier achieves a good functional outcome when used in selected cases such as small diameter autografts, age >40 years old and in cases where non-compliance to rehabilitation is expected.


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