# 8–11 year results of LARS augmented hamstring in anterior cruciate ligament reconstruction surgery: Incidence of synovitis and failures

## TL;DR

This study compared long-term outcomes of ACL surgery using LARS synthetic grafts with hamstring grafts and found no significant difference in failure rates or synovitis.

## Contribution

Long-term (8–11 year) clinical outcomes of LARS-augmented ACL surgery are reported for the first time.

## Key findings

- Revision rates were 5.7% for LARS-augmented and 12.5% for hamstring-only groups, but not statistically significant.
- No synovitis was observed in either group over the 8–11 year follow-up period.
- LARS grafts provided appropriately sized grafts and were safe in the long term.

## Abstract

Anterior cruciate ligament (ACL) injury account for the majority of sport related knee ligament injuries and ACL reconstruction surgery is one of the most performed operations in the young adult population. Various graft types have been used to reconstruct the ACL, however there is no consensus on the best option. Concerns about quality and size of the graft and its effects on success of the reconstruction remain. Synthetic grafts have also been used for a long time as a substitute or to augment biological grafts however, concerns about early failure and particle related synovitis have limited their intra-articular use. The most common synthetic graft option still in use is the Ligament Augmentation and Reconstruction System (LARS).

The study is a case controlled retrospective comparison of 102 consecutive cases reporting 8–11 year results in relation to clinical outcomes revision rates and synovitis of ACL reconstruction surgery using LARS synthetic grafts as an augment when compared with hamstring graft alone.

The study found a mean follow up was 9 years and one month (8–11 years) and revision rate was 5.7 % for the LARS augmented group and 12.5 % for the Hamstring group, but not significantly different, odds ratio 0.4 (C.I: 0.1179–1.555, p = 0.255). LARS augmented autograft ACL reconstruction had similar results at 8–11 years when compared to autograft only reconstructions. No synovitis was noted in either group.

LARS ensures an appropriately sized graft, is safe and not associated with synovitis in our cohort at 8–11 year follow up.