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Posterior cruciate ligament reconstruction for chronic lesions: clinical experience with hamstring versus ligament advanced reinforcement system as graft

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Abstract

Purpose

The aim of this study was to compare clinical and laximetric results in chronic, isolated posterior cruciate ligament (PCL) rupture repairs, using either a hamstring graft or an artificial ligament (ligament advanced reinforcement system (LARS®)).

Methods

Sixteen patients presenting with an isolated unilateral PCL rupture were included in this retrospective study. Initially, eight underwent a PCL reconstruction using a hamstring tendon autograft (hamstring group), and over a later period, eight further patients underwent a reconstruction using an artificial ligament with a new procedure.

Results

Fifteen patients were male and one female, with an average age of 29.3 years. All patients were operated on within an average time of 18 months post-injury. Pre-operative posterior laxity was equivalent (p = 0.309), 18.25 mm on average for the hamstring group and 18.75 mm for the LARS group. With an average follow-up of 24 months, residual posterior laxity was significantly improved, decreasing from 18.25 to 7.37 mm for the hamstring group (p < 0.05) with a median at 7.5 mm and from 18.75 to 5.25 mm for the LARS group (p < 0.05) with a median at 5 mm. The improvement in laxity for the hamstring group was 60% and 71.5% for the LARS group. The LARS group compares favourably (p = 0.003 and 0.01). Tegner activity level improved significantly following ligamentoplasty, with no difference between the two groups (p = 0.4). Likewise, there was no significant difference in the Lysholm and IKDC scores between the two groups (p = 0.4).

Conclusion

The initial hypothesis of this study was proven correct. Nevertheless, a longer term study is necessary to assess the consequences of residual laxity in hamstring grafts and the long-term behaviour and tolerance of the LARS artificial ligament.

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Acknowledgement

Acknowledgements to Pr Jean Yves Jenny for his advice for the statistics.

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Authors and Affiliations

  1. Department of Osteoarthritis and Sport Surgery, Grenoble-Alpes CHU, South Teaching Hospital, Kimberley Avenue, BP 338, 38434, Échirolles, Cedex, France

    D. Saragaglia, F. Francony, J. Gaillot, R. Pailhé, B. Rubens-Duval & G. Lateur

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  1. D. Saragaglia
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  2. F. Francony
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  3. J. Gaillot
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  4. R. Pailhé
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  5. B. Rubens-Duval
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Correspondence to D. Saragaglia.

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Informed consent was obtained from all individual participants included in the study.

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Saragaglia, D., Francony, F., Gaillot, J. et al. Posterior cruciate ligament reconstruction for chronic lesions: clinical experience with hamstring versus ligament advanced reinforcement system as graft. International Orthopaedics (SICOT) 44, 179–185 (2020). https://doi.org/10.1007/s00264-019-04434-7

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  • DOI: https://doi.org/10.1007/s00264-019-04434-7

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