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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Surgery Scheduled For ACL Reconstruction. Suggested To Choose Between Hamstring Ligament And LARS Surgery. Opinion?

Hi,
Im scheduled for surgery this monday for an acl re-construction. The orthopedic surgeon offered me the "old" hamstring ligament and the LARS surgery. I still can decide which way to go as there seems to be many other surgeons in Australia still saying use the the hamstring ligament. My main interest in the LARS is the recovery time for return to work and sport, but the concern is that it is an artificial ligamant in the body and the lack of long term research and usuage of LARS. I know you can't tell me which way to go, but ypu might be able to give me more information.
Thankyou,
Shane.
posted on Tue, 9 Apr 2013
Twitter Tue, 9 Apr 2013 Answered on
Twitter Wed, 10 Apr 2013 Last reviewed on
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Orthopaedic Surgeon,  's  Response

For the last 15years,LARS has been used with very good results, with earlier mobilization.Depending on surgeons skill and experience, it would be preferable against hamsting.For your information I am pasting the comparisan below--

SYNTHETIC (LARS ligament)
Extreme loading capacity without elongation;
Rapid in growth of fibroblast(healthy tissue);
Absolute tissue tolerance;
Rapid recovery 6-8 weeks (no long period of immobilization required);
No muscle atrophy;
No cases of reactive synovitis(effusion of joint) or of infection;
No risk of weakening the joint (since no anatomical material is taken);
Replacing of a synthetic ligament is as easy as its initial installment.
AUTOGENOUS(Hamstring) (from patient)
Long period of immobilization required;
Chances for Muscular atrophy;
Long period of revascularization;
Limitation of graft in case of revision;
Long phase of therapy for a good rehabilitation;
Full sports are generally authorized after 6 months.
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Orthopaedic Surgeon,  Dr. Gautam Sipani's  Response
Hello Shane, you are true and long term results are not available for LARS but quadrupled semi tendinosus graft is treatment of choice till date as per literature and I have seen myself long term good results with it. Time tested. My suggestion..go for it.
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Surgery Scheduled For ACL Reconstruction. Suggested To Choose Between Hamstring Ligament And LARS Surgery. Opinion?

For the last 15years,LARS has been used with very good results, with earlier mobilization.Depending on surgeons skill and experience, it would be preferable against hamsting.For your information I am pasting the comparisan below-- SYNTHETIC (LARS ligament) Extreme loading capacity without elongation; Rapid in growth of fibroblast(healthy tissue); Absolute tissue tolerance; Rapid recovery 6-8 weeks (no long period of immobilization required); No muscle atrophy; No cases of reactive synovitis(effusion of joint) or of infection; No risk of weakening the joint (since no anatomical material is taken); Replacing of a synthetic ligament is as easy as its initial installment. AUTOGENOUS(Hamstring) (from patient) Long period of immobilization required; Chances for Muscular atrophy; Long period of revascularization; Limitation of graft in case of revision; Long phase of therapy for a good rehabilitation; Full sports are generally authorized after 6 months.