Anterior Cruciate Ligament Reconstruction Using a Hollow Ligament Advanced Reinforcement System Semitendinosus...

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomechanical Engineering

Background:

• Anterior Cruciate Ligament (ACL) injuries often require reconstruction, with anterolateral complex (ALC) augmentation gaining importance for rotational stability.
• Traditional ACL reconstruction techniques can involve significant autologous tendon harvesting, potentially leading to donor site morbidity.
• Restoring immediate knee stability is crucial for early rehabilitation and return to athletic activity.

Purpose of the Study:

• To describe an alternative surgical technique for ACL reconstruction combined with ALC augmentation.
• To evaluate the use of a hollow LIGAMENT ADVANCED REINFORCEMENT SYSTEM (LARS) with autologous tendons for knee reconstruction.
• To highlight the benefits of reduced autologous tissue harvesting and enhanced early rotational stability.

Main Methods:

• Arthroscopic exploration and assessment of the ACL and ALC.
• Graft preparation using semitendinosus and gracilis tendons combined with a hollow LARS device.
• Surgical steps including tunnel drilling in the femur and tibia, and graft fixation.
• Utilizing the LARS device to augment autologous grafts and provide immediate structural support.

Main Results:

• The described technique reduces the need for extensive autologous tendon harvesting.
• It minimizes the risk of neurovascular injury associated with larger graft harvests.
• The procedure facilitates immediate restoration of knee rotational stability, enabling early postoperative mobilization.
• The hollow LARS ligament provides structural support, augmenting smaller autografts and enhancing early mechanical strength.

Conclusions:

• This surgical technique offers a viable alternative for ACL reconstruction with ALC augmentation.
• It is particularly beneficial for patients with limited autologous graft options or those requiring revision surgery.
• The combination of LARS and autologous tendons promotes early knee stability and functional recovery.
• Potential limitations include the learning curve and the risk of femoral tunnel malpositioning.