Objective: To compare the therapeutic effect of anterior cruciate ligament (ACL) reconstruction by means of four-strand semitendinosus tendon autograft and ligament 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 ligament (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 > 0.05). The ranges of motion, stability and complication 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 than 3 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 > 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 fair cases) 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 > 0.05). The joint motion capability 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 > 0.05). The knee extension in 2 cases was 5 degrees less than the normal, and in 5 cases 5-10 degrees 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 < 0.05). There was no sign of synovitis in both groups.
Conclusion: The recent clinical result of ACL reconstruction with the four-strand semitendinosus tendon autograft or LARS artificial ligament by arthroscopy is satisfactory without significant difference. LARS can shorten the recovery time without complications such as synovitis in 2-year follow-up.