KS7: THE LARS ACL – IS THE ENTHUSIASM JUSTIFIED?

Abstract

Introduction: The use of the LARS (Ligament Augmentation and Reconstruction System^®, Corin) ligament for the surgical treatment of ACL deficiency has increased exponentially in Australia, particularly over the past 12 months. Given the well documented failure of synthetic ACL implants used during the 1980s, a review of the current literature regarding the LARS is required.

Methods and Results: There is a paucity of current literature regarding the use of the LARS in the surgical management of ACL deficiency. 1 laboratory based, and 3 clinical publications were available for review. The transcriptions of 4 podium presentations were also available for review. Therefore, a total of 8 papers were analysed.

The maximum duration of patient follow-up in any of the papers was 10 years. All papers presented results of at least 2 years follow up. In all papers, standardized outcome measures produced results equivalent to those obtained using traditional ACL reconstruction techniques. Complications were detailed in all papers, with each reporting the absence of synovitis in patients for whom the LARS had been used.

Conclusion: Whilst there is insufficient long-term evidence to support the use of the LARS, the early results are promising. In particular, the problem of postoperative synovitis and synthetic ligament abrasion that led to the spectacular failure of early synthetic ACL designs appears to be absent in patients treated with the LARS. The LARS should be used in accordance with the strict patient selection criteria and technical guidelines recommended by the designing surgeon.