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).
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.
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.
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.