ACL Reconstruction with the LARS Ligament

Anterior cruciate ligament is one of the four major ligaments of the knee that connects the femur (thigh bone) to the tibia (shin bone) and helps stabilize the knee joint.Anterior cruciate ligament (ACL) injury is one of the common injuries of the knee. An injury to ACL most commonly occurs during sports or activities that involve twisting, overextending, landing from a jump incorrectly,and abrupt change in direction or speed of movements.

When you injure your ACL, you might hear a “popping” sound or feel as though the knee has given out.You might experience swelling, pain, and gait disturbances.If left untreated, a torn ACL may lead to instability and recurrent giving way of the knee.

With the new advancement in technology, it’s now possible to repair the torn ACL with the utilization of an artificial ligament (LARS)that is biocompatible with the native tissues of the body, rather than the traditional methodof using a hamstring or patella tendon for replacement or reconstruction of a new ligament.Ligament Augmentation Reinforcement System (LARS) ligament is a new era of soft tissue reconstructiondesigned to mimic the normal anatomic fibres. It has yielded clinically-proven results overa vast period of time.

LARS acts as a supporting band within the knee to promote healing of the ruptured ACL.LARS ligaments are proposed for the intra or extra-articulation of ruptured ligaments. It will either be implanted as asingle or a combination with suturing to the remnant of the injured ligament for reconstruction.

LARS is extensively used in the reconstruction of both anterior and posterior cruciate ligaments of the knee. These synthetic ligaments vary in size and strengthto support the impaired tissues. A knee surgeon selects the ligament based on the weight and activity level of the patient.

The latest LARS is composed of polyethylene terephthalate – an industrial-strength polyester fibre. The LARS ACLencompasses a pattern of intra-articular fibres arranged in either clock-wise or anti-clockwise direction to imitate the original ligaments within the knee. The structure of the LARS permits for new tissue ingrowth whereas the ruptured ligament remnants grow into the graft to increase the strength and stability of the ligament. LARS is usually indicated in acute injuries or in people with a good ACL stump that has a rich blood supply.

Surgical technique:

The goal of ACL reconstruction surgery is to tighten your knee and to restore its stability.

This procedure uses minimally invasive technique; a smaller incision is placed than the traditional large open incision. LARS is associated with minimal complications since an artificial ligament is used rather a native tissue graft.

An arthroscopic technique is employed to place the new ligament in situ. Tiny holeswill be drilled intrusively through the remnants of the original ACL. The ligament is fit in the bony holes and is enclosed by the native tissue. Additional fixation is done using titanium screwsto hold it into place while the ligament heals into the bone.

Advantages of using a LARS ligament in the repair of a torn ACL:

Some of the benefitsof using a LARS ligament in the repair of a torn ACLinclude:

  • Minimal trauma to the surrounding structures
  • Shorter recovery time with less post-surgical complications
  • Greater range of motion withless post-operative pain
  • Decreased muscle atrophy

Post-operative care

Following are the post-surgical guidelines to be followed after the surgery

  • Take Medications and antibiotics to help alleviate pain and inflammationas prescribed by your doctor
  • Apply ice packs to reduce post-operative swelling
  • Start rehabilitation (physiotherapy) as recommended by your knee surgeon
  • No restriction to range of motion
  • Weight bearing status: Crutches may be used and you should begin appropriate exercises to strengthen the muscles
  • Return to sportsonce the knee has regained normal strength and function.