【Abstract】 Objective To compare the therapeutic effect of anterior cruciate l igament (ACL) reconstruction bymeans of four-strand semitendinosus tendon autograft and l igament advanced reinforcement system (LARS) by arthroscopy. Methods From July 2002 to April 2005, 42 patients underwent ACL reconstruction by arthroscopy. Twenty-seven patients were treated by four-strand semitendinosus tendon autograft (semitendinosus tendon autograft group), including 22 males and 5 females, with the age from 20 years to 52 years. Among these patients, there were 12 sports injuries, 8 traffic accidents and 7 other injuries. There were 16 cases of left knees and 11 of right knees. The pre-operation Lysholm score was 50.70 ± 6.68, and the course of the disease was 2 to 12 months. Other 15 patients were treated by LARS artificial l igament (LARS group), including 12 males and 3 females, with the age from 17 years to 40 years. Among these patients, there were 8 sports injuries, 4 traffic accidents and 3 other injuries. There were 6 cases of left knees and 9 of right knees. The pre-operation Lysholm score was 50.20 ± 6.22, and the course of the disease was 3 to 12 months. There was no statistically significant difference between the two groups (P gt; 0.05). The ranges of motion, stabil ity and compl ication of the knee were evaluated during the follow-up. Results All incisions healed at the first stage. The patients in the semitendinosus tendon autograft group were followed up for 22 months to 43 months, while 18 months to 40 months in the LARS group. There were 5 patients (19%) whose tensile gap was more than3 mm when the max tensile force text was done in the semitendinosus tendon autograft group, and 3 patients (20%) in the LARS group. The Lysholm score was 87.80 ± 3.41 in the semitendinosus tendon autograft autograft group, and 88.90 ± 3.30 in the LARS group. There was no statistically significant difference between the two groups (P gt; 0.05). The final evaluation based on the improved Lysholm classification standard showed the choiceness rate was 92.6% (18 excellent cases, 7 good cases and 2 faircases) in the semitendinosus tendon autograft group, and 93.3% (11 excellent cases, 3 good cases, 1 fair case) in the LARS group. There was no statistically significant difference between the two groups (P gt; 0.05). The joint motion capabil ity evaluation, according to the Tegner standard, showed 3 to 6 class (with the average class of 4.93) in the semitendinosus tendon autograft group, and 3 to 7 class (with the average class of 5.03) in the LARS group. There was no statistically significant difference (P gt; 0.05). The knee extension in 2 cases was 5° less than the normal, and in 5 cases 5-10° less than the normal in the semitendinosus tendon autograft group. But in all cases in the LARS group, joint motion recovered to the normal (P lt; 0.05). There was no sign of synovitis in both groups. Conclusion The recent cl inical result of ACL reconstruction with the four-strand semitendinosus tendon autograft or LARS artificial l igament by arthroscopy is satisfactory without significant difference. LARS can shorten the recovery time without compl ications such as synovitis in 2-year follow-up.
Objective To explore the operative techniques and prel iminary cl inical effect of arthroscopic reconstruction of posterior cruciate l igament (PCL) using l igament advanced reinforcement system (LARS). Methods From June 2006 to July 2007, 9 patients with PCL rupture were treated with LARS under arthroscopic observation. There were 8 males and 1 female, aged 23-49 years old. The left knee was involved in 3 cases and the right knee in 6 cases. The main causes of injuries were sports in 5 cases, fall ing in 1 case and traffic accident in 3 cases. The time from injury to reconstruction was6-20 days (13.6 days on average). There were 2 cases with associated medial meniscus injury and 1 with lateral meniscus injury. X-ray films showed no avulsion fracture of tibial plateau was found. The preoperative Lysholm score was 40-55 (50 on average). According to the preoperative international knee documentation commitee (IKDC) grading, 1 case was graded as C and 8 as D. The Lachman test showed that there was 1 case (+), 6 cases (++) and 2 cases (+++). The operation was performed under arthroscopic observation. The tibial isometric point and tunnel were drilled with the help of a drill bit guide, while the femoral isometric point and tunnel were drilled under the C-arm X-ray machine. The diameter of the bone tunnels was 6 mm, while the diameters of LARS artificial l igaments and canulated interference screws were 7 mm. Results All the patients were regularly followed up for 8-16 months (10.5 months on average). The postoperative Lysholm score was 70-95 (85 on average). There were 5 cases of excellent, 3 of good and 1 of fair, with the choiceness rate of 88%. The postoperative IKDC grading showed that 7 cases were graded as A and 2 as B. The Lachman test showed that no case was positive. Compl ications such as infection, spontaneous rupture or laxity of graft were not observed. Conclusion PCL arthroscopic reconstruction with the use of LARS artificial l igaments leads to a good anatomic reconstruction and knee function with minor injury, rapid recovery and satisfactory cl inical effect.