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LARS synthetic ligaments for the acute management of 111 acute knee dislocations: effective surgical treatment for most ligaments

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The purpose of this study was to describe the longitudinal outcomes of acute repair and augmentation for the reconstruction of dislocated knees, using LARS synthetic ligaments.

Methods

Patients with a knee dislocation surgically treated using LARS synthetic ligament augmentation, with a minimum follow-up of 24 months, were enrolled between 1996 and 2014. Range of motion, Lachman, pivot shift, posterior drawer, step off sign, valgus, varus, KT-1000 arthrometer, Telos technique, IKDC, Lysholm, Tegner, and Meyers scores were obtained every 2 years up to 10 years.

Results

Median age was 32.1 years (IQR 23.2–43.3) at time of surgery. Median time from trauma to surgery was 9 days and mean follow-up time was 6.6 years. Median questionnaire scores were: Lysholm 79.5 (IQR 65.0–89.0), Tegner 4.0 (IQR 3.7–6.0), Meyers 3.0 (IQR 3.0–4.0), and mean IKDC was 63.8 (SD 18.9). Median flexion and extension of the injured knee was 124° (IQR 115–129.5) and 0° (IQR − 5 to 0), respectively. Median KT-1000 differential was 0.7 mm (IQR 0.1–3.1) for ACL and 0.9 mm (IQR 0.2–1.4) for PCL. Mean differential for Telos was 2.5 mm (SD 5.8) for ACL, 4 mm (IQR 2–6.3) for PCL 30°, and 8.2 mm (SD 4.4) for PCL 90° (consistent with PCL laxity). More than 90% of patients had good anterior articular stability and > 60% of patients had good posterior articular stability.

Conclusions

Acute repair and augmentation of knee dislocations with LARS synthetic ligaments resulted in satisfactory outcomes for the ACL and collateral structures. Telos stress radiography showed PCL laxity in more than half of cases despite low laxity results with KT-1000. The perception of patients about knee function was sustained in time.

Level of evidence

IV.

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Acknowledgements

We would like to thank Dr. Fernando Rosa for his precious contribution to manuscript redaction, Mr. David Yin for his help with language form, and Dr. Alexandre Renaud for his help in the development of this project.

Funding

Dr. Pierre Ranger reports grants from Johnson & Johnson, support as a consultant from Smith & Nephew, Corin, Bioventus, Sanofi Canada, and support for development of educational presentations by Horizon Pharma outside of the conducted work. Josée Delisle also reports support for personal fees from Amgen Canada and Eli Lilly outside of the conducted work.

Author information

Authors and Affiliations

  1. Orthopaedic Research Center, Hôpital du Sacré-Coeur de Montréal, 5400, boulevard Gouin Ouest, Montreal, QC, H4J 1C5, Canada

    Pierre Ranger, Andréa Senay & Josée Delisle

  2. Hôpital Jean-Talon, 1385 rue Jean-Talon est, Montreal, H2E 1S6, Canada

    Pierre Ranger, Marc Lacelle & Josée Delisle

  3. Université de Montréal, 2900 bl. Edouard-Montpetit, Montreal, H3T 1J4, Canada

    Pierre Ranger, Andréa Senay & Geneviève Rochette Gratton

Authors
  1. Pierre Ranger
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  2. Andréa Senay
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  4. Marc Lacelle
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  5. Josée Delisle
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Contributions

PR is the principle investigator of this study, thus contributing to all aspects of it; conception and design, protocol redaction, ethics approval, patient recruitment, data acquisition, interpretation of data, and drafting and revision of manuscript. AS contributed substantially to literature review, data collection by recruiting patients, organising follow-up visits, data entry, performing data analysis, and manuscript redaction. GRG has been in charge of database development, organization of clinics and patients’ follow-up for 2 years, and has contributed to manuscript redaction and revision. ML has contributed to conception of the study in terms of functional assessments, and has proceeded to all functional evaluations of patients during clinics over the study period and to the revision of the manuscript. JD, as the study coordinator, has contributed substantially to conception, design, literature review, protocol redaction, ethics approval, research team schedule, study planning, and manuscript revision.

Corresponding author

Correspondence to Josée Delisle.

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Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the Hôpital du Sacré-Coeur de Montréal ethic research committee in Montréal, Québec, Canada (IRB #2008-03-116; 2010 − 285). All procedures performed in this study were in accordance with the ethical standards of the hospital’s ethic research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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All subjects provided informed consent.

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Ranger, P., Senay, A., Gratton, G.R. et al. LARS synthetic ligaments for the acute management of 111 acute knee dislocations: effective surgical treatment for most ligaments. Knee Surg Sports Traumatol Arthrosc 26, 3673–3681 (2018). https://doi.org/10.1007/s00167-018-4940-4

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