Anterior Cruciate Ligament Reconstruction: Results of LARS Artificial Ligament Versus Four-Strand Hamstring Tendon Autograft

Abstract

Background: This study compares the four-strand hamstring tendon (HT) autograft and the ligament advanced reinforcement system (LARS) artificial ligament for functional outcomes after anterior cruciate ligament (ACL) reconstruction.

Material and Methods: This retrospective study included 101 patients (89 males and 12 females) with isolated anterior cruciate ligament injury who underwent arthroscopic ACL reconstruction using a four-strand HT autograft (50 patients), or LARS ligament (51 patients), between 2017 and 2020. Eligible participants were followed for the mean of 32.5 months (range 12 to 48 months) and assessed functionally using the Knee Injury and Osteoarthritis Outcome Score (KOOS), Lysholm knee score, and International Knee Documentation Committee (IKDC) score.

Results: The mean age of patients was 29.9 ± 6.0 years (range 19-47 years). Sports injuries were the most common mechanism of injury in both groups. According to the Lysholm knee score classification, 86% (n: 43) of patients in the HT group had excellent and good knee function, while 78.5% (n: 40) reported excellent and good knee function in the LARS group (p=0.02). The mean of the Lysholm knee score, IKDC score, and KOOS subscales in the LARS group was higher than the HT group. However, this difference was not statistically significant.

Conclusion: This study showed that the short-term functional outcomes of ACLR surgery were slightly better with four strand HT grafts than LARS ligaments. However, patients' characteristics and the surgeon’s experience should be considered in evaluating the best surgical option for patients with ACL injury.