Left Knee arthroscopy
ACL reconstruction with LARS. Note the ACL stump is repaired as it shrouds the LARS ligament graft, which is invisible.
LARS is a synthetic scaffold that is used to augment the repaired native soft tissue. Naturally it relies on the on ability and feasibility to repair the native torn ligament. The LARS ligaments were developed and used initially by the French and recently has seen a surge in use in the Australian Elite athletes. It has certain advantages as it may allow quicker rehabilitation time since patient’s own tissue are spared of surgical trauma. It has a place in selected population who fulfill the criteria, which includes a relatively recent injury and availability of a suitable native ligament stump to repair. We do not believe in using a synthetic scaffold in the absence of native biological tissue.
LARS graft are designed to be used in relatively recent injuries or where there is a partial tear of the ligaments or where a good stump of the old ruptured ligament is present. The idea is to provide a scaffold in the form of LARS, which will allow the native tissue to heal in an appropriate fashion. The remaining stump of the torn ligament is repaired at the same sitting.
The grafts that we commonly use in our practice are;
We have also used LARS in reconstruction of unusual tears such as;
We have published the work on use of Quadriceps Tendon graft for repair of Hip abductors.
The use of LARS enables the patient to return to sport early as there is no donor site morbidity and the graft is strong enough. However, it must be borne in mind that Ligament reconstruction is major surgery that requires skilled rehabilitation.