Skip to main content
SpringerLink
Log in

Arthroscopic Reconstruction of the Posterior Cruciate Ligament with a Ligament-advanced Reinforcement System and Hamstring Tendon Autograft: A Retrospective Study

  • Published:
Current Medical Science Aims and scope Submit manuscript

Abstract

Objective

Both ligament-advanced reinforcement system (LARS) and hamstring tendon autograft can serve as grafts for posterior cruciate ligament (PCL) reconstruction. However, few studies have compared the effectiveness of these two approaches. This study therefore aimed to compare the clinical efficacy of arthroscopic reconstruction of the PCL using either the LARS or hamstring tendon autograft.

Methods

A total of 36 patients who underwent PCL reconstruction were retrospectively analyzed. Within this cohort, 15 patients received a reconstruction using the LARS (LARS group) and 21 using the hamstring tendon autograft (HT group).

Results

The pre- and post-operative subjective scores and knee stability were evaluated and the 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 significantly improved in both groups (P<0.05). Six months after operation, Lysholm scores and IKDC subjective scores were higher in the LARS group than in the HT group (P<0.05). Nonetheless, the last follow-up showed no significant differences in the functional scores or the posterior drawer test between the two groups (P>0.05). In the LARS and HT groups, 12 and 9 patients, respectively exhibited KT1000 values <3 mm, with the difference being statistically significant (P<0.05). In the HT group, the diameter of the four-strand hamstring tendon was positively correlated with height (P<0.05), which was 7.37±0.52 mm in males and 6.50±0.77 mm in females (P<0.05).

Conclusion

Both LARS and hamstring tendon approaches achieved good efficacy for PCL reconstruction, but patients in the LARS group exhibited faster functional recovery and better knee stability in the long term. LARS is especially suitable for those who hope to resume activities as early as possible.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Fanelli GC, Edson CJ. Posterior cruciate ligament injuries in trauma patients: Part II. Arthroscopy, 1995,11(5):526–529

    Article  CAS  Google Scholar 

  2. Fanelli GC, Beck JD, Edson CJ. Current concepts review: the posterior cruciate ligament. J Knee Surg, 2010,23(2):61–72

    Article  Google Scholar 

  3. Panigrahi R, Kumari Mahapatra A, Priyadarshi A, et al. Outcome of Simultaneous Arthroscopic Anterior Cruciate Ligament and Posterior Cruciate Ligament Reconstruction With Hamstring Tendon Autograft: A Multicenter Prospective Study. Asian J Sports Med, 2016,7(1):e29287

    Article  Google Scholar 

  4. Sun K, Zhang J, Wang Y, et al. Arthroscopic reconstruction of the anterior cruciate ligament with hamstring tendon autograft and fresh-frozen allograft: a prospective, randomized controlled study. Am J Sports Med, 2011,39(7):1430–1438

    Article  Google Scholar 

  5. Chen CP, Lin YM, Chiu YC, et al. Outcomes of arthroscopic double-bundle PCL reconstruction using the LARS artificial ligament. Orthopedics, 2012,35(6):e800–806

    Article  Google Scholar 

  6. Gliatis J, Anagnostou K, Tsoumpos P, et al. Complex knee injuries treated in acute phase: Long-term results using Ligament Augmentation and Reconstruction System artificial ligament. World J Orthop, 2018,9(3):24–34

    Article  Google Scholar 

  7. 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. Internat Orthop, 2020,44(1):179–185

    Article  CAS  Google Scholar 

  8. Canale ST, Beaty HJ. Campbell’s Operative Orthopaedics. Elsevier, Singapore; 2008.

  9. Lysholm J, Gillquist J. Evaluation of knee ligament surgery results with special emphasis on use of a scoring scale. Am J Sports Med, 1982,10(3):150–154

    Article  CAS  Google Scholar 

  10. Anderson AF, Irrgang JJ, Kocher MS, et al. The International Knee Documentation Committee Subjective Knee Evaluation Form: normative data. Am J Sports Med, 2006,34(1):128–135

    Article  Google Scholar 

  11. Tegner Y, Lysholm J. Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res, 1985(198):43–49

    Google Scholar 

  12. Xu X, Huang T, Liu Z, et al. Hamstring tendon autograft versus LARS artificial ligament for arthroscopic posterior cruciate ligament reconstruction in a long-term follow-up. Arch Orthop Trauma Surg, 2014,134(12):1753–1759

    Article  Google Scholar 

  13. Mardani-Kivi M, Karimi-Mobarakeh M, Keyhani S, et al. Hamstring tendon autograft versus fresh-frozen tibialis posterior allograft in primary arthroscopic anterior cruciate ligament reconstruction: a retrospective cohort study with three to six years follow-up. Int Orthop, 2016,40(9):1905–1911

    Article  Google Scholar 

  14. Rai S, Jin SY, Rai B, et al. A Single Bundle Anterior Cruciate Ligament Reconstruction (ACL-R) Using Hamstring Tendon Autograft and Tibialis Anterior Tendon Allograft: A Comparative Study. Curr Med Sci, 2018,38(5):818–826

    Article  CAS  Google Scholar 

  15. Jung YB, Tae SK, Lee YS, et al. Active non-operative treatment of acute isolated posterior cruciate ligament injury with cylinder cast immobilization. Knee Surg Sports Traumatol Arthrosc 2008,16(8):729–733

    Article  Google Scholar 

  16. Gao K, Chen S, Wang L, et al. Anterior cruciate ligament reconstruction with LARS artificial ligament: a multicenter study with 3- to 5-year follow-up. Arthroscopy, 2010,26(4):515–523

    Article  Google Scholar 

  17. Ahn JH, Wang JH, Lee YS, et al. Anterior cruciate ligament reconstruction using remnant preservation and a femoral tensioning technique: clinical and magnetic resonance imaging results. Arthroscopy, 2011,27(8): 1079–1089

    Article  Google Scholar 

  18. Li B, Wen Y, Wu H, et al. Arthroscopic single-bundle posterior cruciate ligament reconstruction: retrospective review of hamstring tendon graft versus LARS artificial ligament. Internat Orthop, 2009,33(4):991–996

    Article  CAS  Google Scholar 

  19. Janssen RP, Scheffler SU. Intra-articular remodelling of hamstring tendon grafts after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc, 2014,22(9):2102–2108

    Article  Google Scholar 

  20. Marumo K, Saito M, Yamagishi T, et al. The “ligamentization” process in human anterior cruciate ligament reconstruction with autogenous patellar and hamstring tendons: a biochemical study. Am J Sports Med, 200533(8):1166–1173

    Article  Google Scholar 

  21. Girgis FG, Marshall JL, Monajem A. The cruciate ligaments of the knee joint. Anatomical, functional and experimental analysis. Clin Orthop Relat Res,1975(106):216–231

    Google Scholar 

  22. Tao C, He A, Wang W. Anatomy and clinical value of the posterior cruciate ligament of knee joint. Chin J Clin Anat (Chinese), 2007,25(02):176–178

    Google Scholar 

  23. Chen L, Yu J, Ao Y, et al. Morphological Measurement of PCL Insertion and Optimized Tunnel Diameter for PCL Reconstruction. Chin J Sports Med (Chinese), 2011,30(10):911–915, 947

    Google Scholar 

  24. Li B, Wang JS, He M, et al. Comparison of hamstring tendon autograft and tibialis anterior allograft in arthroscopic transtibial single-bundle posterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc, 2015,23(10):3077–3084

    Article  Google Scholar 

  25. Conte EJ, Hyatt AE, Gatt CJ, et al. Hamstring autograft size can be predicted and is a potential risk factor for anterior cruciate ligament reconstruction failure. Arthroscopy, 2014,30(7):882–890

    Article  Google Scholar 

  26. Bianchi N, Sacchetti F, Bottai V, et al. LARS versus hamstring tendon autograft in anterior cruciate ligament reconstruction: a single-centre, single surgeon retrospective study with 8 years of follow-up. Eur J Orthop Surg Traumatol, 2019,29(2):447–453

    Article  Google Scholar 

  27. LI Y, Zhang H, Xiao S, et al. Effectiveness comparison of LARS artificial ligament and autogenous hamstring tendon in one-stage reconstruction of anterior and posterior cruciate ligaments. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi (Chinese), 2020,34(5):1–7

    CAS  Google Scholar 

  28. Brunet P, Charrois O, Degeorges R, et al. Reconstruction of acute posterior cruciate ligament tears using a synthetic ligament. Rev Chir Orthop Reparatrice Appar Mot (French), 2005,91(1):34–43

    Article  CAS  Google Scholar 

  29. Chiang LY, Lee CH, Tong KM, et al. Posterior cruciate ligament reconstruction implemented by the Ligament Advanced Reinforcement System over a minimum follow-up of 10 years. Knee, 2020,27(1):165–172

    Article  Google Scholar 

  30. Sun J, Wei XC, Li L, et al. Autografts vs Synthetics for Cruciate Ligament Reconstruction: A Systematic Review and Meta-Analysis. Orthop Surg, 2020,12(2):378–387

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopedics, the First Medical Centre, Chinese PLA General Hospital, Beijing, 100853, China

    Yang Luo, Zhi-gang Wang, Zhi-jiang Li & Min Wei

Authors
  1. Yang Luo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Zhi-gang Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Zhi-jiang Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Min Wei
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Min Wei.

Additional information

Conflict of Interest Statement

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Luo, Y., Wang, Zg., Li, Zj. et al. Arthroscopic Reconstruction of the Posterior Cruciate Ligament with a Ligament-advanced Reinforcement System and Hamstring Tendon Autograft: A Retrospective Study. CURR MED SCI 41, 930–935 (2021). https://doi.org/10.1007/s11596-021-2446-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11596-021-2446-7

Key words

Search

Navigation