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Foreign Body Reaction Associated With Artificial LARS Ligaments: A Retrieval Study
Zachary Paul Sinagra1, Alan Kop2, Moreica Pabbruwe2
1Department of Orthopaedics, Royal Perth Hospital, Perth, Australia.
Orthopaedic Journal of Sports Medicine
|December 15, 2018
Summary
Foreign body reactions are associated with Ligament Augmentation and Reconstruction System (LARS) ligaments. Complete fibrous tissue ingrowth may reduce these adverse immune responses in artificial ligament use.
Area of Science:
- Orthopedic surgery
- Biomaterials science
- Immunology
Background:
- Artificial ligaments have been used for ligamentous injuries since the 1970s.
- Early artificial ligaments had high rates of rupture and inflammation.
Purpose of the Study:
- To investigate if Ligament Augmentation and Reconstruction System (LARS) ligaments cause intra-articular foreign body reactions.
Main Methods:
- Case series (Level of evidence, 4).
- 14 explanted LARS ligaments underwent macroscopic and histological analysis.
- 1 sample underwent scanning electron microscopy to assess inflammation and fibrous tissue ingrowth.
Main Results:
- A foreign body reaction was observed in 10 of 14 explanted LARS ligaments.
- Seven samples showed fibrous tissue ingrowth, with 5 having incomplete ingrowth and associated immune response.
- Two samples with extensive fibrous coverage had no foreign body reaction.
Conclusions:
- LARS ligaments are associated with significant foreign body reactions, despite design improvements.
- Complete fibrous tissue ingrowth may mitigate foreign body reactions to LARS ligaments.
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