Analysis of Vastus Lateralis and Vastus Medialis Activities in Men the Late Post-Surgery Period after ACL Reconstruction with LARS Synthetic Ligament

Background. The aim of the study was to assess the activity of the vastus lateralis (VAL) and vastus medialis (VAM) within 3-5 years after anterior cruciate ligament (ACL) reconstruction with a LARS synthetic ligament (the Ligament Advanced Reinforcement System) compared to muscle activity in the non-operated limb and in the limbs of the controls during selected functional tests. Material and methods. 20 men after ACL reconstruction using LARS synthetic ligament were qualified to the study group. The control group included 20 healthy men. Lysholm scale used to assess the functionality of the knee joint. To test muscle activity, TELEMYO DTS surface electromyography (sEMG) recording kit by Noraxon was used. The examined muscles on both limbs were the VAL and the VAM. The subjects were asked to perform the test-movements (dynamic ascent and descent from 25 cm step and slowly squats). Results. Statistically significant differences were noted only for the values of VAL SA_SD (the quotients of mean sEMG values of the VAL muscle during step ascent - SA and descent -SD; Z=2.83; p=0.0047) and VAM SA_SD (Z=1.98; p=0.0401) parameters. In each analyzed parameter higher values were recorded among people from the control group. Weak but significant correlations were found between the VAL and VAM: SA_SD and the results obtained on the Lysholm Scale. Conclusions. 1. In the group of patients after LARS, quadriceps activity disorders persisted in tested dynamic activities. 2. In the therapy planning or sports training in the distant period after ACL reconstruction with LARS, emphasis should be placed on quadriceps muscle training, and the sEMG test may be helpful in optimizing the management strategy.

Anterior cruciate ligament reconstruction: a look at prosthetics - past, present and possible future

ABSTRACT: Biological tissue autograft reconstruction using the patellar tendon or quadrupled semitendinosus/gracilis tendons has become the most popular procedure in surgical treatment of a ruptured ACL. This article provides a review of the history of the use of prosthetics with respect to ACL reconstruction grafts including Carbon Fibre, Gore-Tex and Dacron prosthetics as well as the Leeds-Keio Artificial Ligament and the Kennedy Ligament Augmentation Device (LAD). Emphasis is placed on the Ligament Advanced Reinforcement System (LARS) as preliminary investigations of its use have been encouraging. Significant progress has been made recently with respect to the understanding of ACL anatomy, composition, biomechanics, and healing processes, leading to innovative techniques using approaches based in tissue engineering principles and computer – assisted surgery. While research into improved ACL treatment options continues, the synthesis of recent advancements provides a new optimism towards the regeneration of an ACL mirroring its original stability, function, and longevity.

Arthroscopic Reconstruction of the Posterior Cruciate Ligament With Ligament Advanced Reinforcement System and Hamstring Tendon Autograft :A Retrospective Study

Background Both Ligament Advanced Reinforcement System(LARS) and hamstring tendon autograft can serve as grafts for posterior cruciate ligament (PCL) reconstruction but few studies compared their differences.This study aimed to compare the clinical efficacy of arthroscopic reconstruction of PCL with LARS and hamstring tendon autograft. Methods 36 patients who had received PCL reconstruction under arthroscopy were retrospectively analyzed. 15 patients received reconstruction using LARS (LARS group) and 21 using hamstring tendon autograft (HT group). The pre- and post-operative subjective scores and knee stability were evaluated. Results 36 patients were followed up for a period of 2 to 10.5 years (4.11±2.0 years on average). The last follow-up showed that functional scores and knee stability were all significantly improved in both groups (P<0.05). Six months after operation, Lysholm scores and IKDC subjective scores were higher in LARS group than in HT group (P<0.05). Nonetheless, the last follow-up showed no statistically significant differences in the functional scores and the posterior drawer test between the two groups (P>0.05). In LARS group and HT group, 12 and 9 patients, respectively had KT1000 values less than 3 mm, with the difference being statistically significant (P<0.05). In HT group, the diameter of the four-strand hamstring tendon was positively correlated with height (P<0.05),which was 7.37±0.52mm in males and 6.50±0.77 mm in females, and the difference was statistically significant (P<0.05). Conclusion Both LARS and hamstring tendon could achieve good clinical efficacy for PCL reconstruction ，but patients in LARS group had faster functional recovery and better knee stability. LARS is especially suitable for those who hope to resume activities as early as possible.