Tuesday, January 4, 2011

LARS For ACL Reconstruction

This may be the best piece of news if you have just torn your anterior cruciate ligament (ACL) and want to return to sports quickly. Please read on for our follow up posting for our current trends in anterior cruciate ligament (ACL) reconstruction management which first started on Mar 19 2009 (http://physiosolutions.blogspot.com/2009/03/current-trends-in-anterior-cruciate.html). This may  revolutionize surgical treatment after serious sports injuries.

Ligament Augmentation and Reconstructive System (LARS) surgery is currently the quickest available technique to return to sports after tearing your ACL. The surgery involves using a ligament created from industrial-strength polyester fibres (PETP or polyethylene terephtalate) to replace the torn ACL.  This procedure has cut the recovery time by a third. The ends of the ruptured ACL are sutured together and the synthetic ligament is passed through the middle of the ACL.

I first read about this technique way back in 2008, but wasn't convinced then. Aussie Rules football player (whom our Australian patients/ readers will be familiar with) Nick Malceski of  the Sydney Swans underwent the procedure after tearing his ACL and was back playing in 12 weeks!

Typical recovery time to return to sport for an ACL tear is 9-12 months. Just ask soccer players like Alan Shearer, Michael Owen, Brazil's Ronaldo (who has torn both ACL's) and Singapore football players like Indra Sahdan and  Mohamed Nor Rahman. They were sidelined 9-12 months after tearing their ACL's. Tiger Woods made his comeback after almost a year off after tearing his.

Currently, elite athletes who have undergone the LARS procedure include AFL star Port Adelaide midfielder David Rodan, Carlton's Brad Fisher, Brisbane Lion's Josh Drummond and NRL Cronulla winger Luke Covell who returned to Rugby League action just 11 weeks after rupturing his ACL.

Records show that there were 10 LARS knee reconstructions in Australia in 2006 and the number surged to 750 in 2009 (including ankle, shoulder and knee surgeries).

Before you go banging on your surgeon's doors for LARS, bear in mind that that are pros as well as cons. While this technique is popular in Europe and Canada, this procedure is not approved by USA medical authorities as there are fears that the synthetic implant may have adverse effects 5-10 years down the track. Plus no surgeon in Singapore can do the procedure yet.

Stay tuned as we discuss the pros and cons of the LARS procedure and the current published evidence so far in our next post.

* Picture of LARS graft from Dericks, G 1995, ‘Ligament Advanced Reinforcement System Anterior Cruciate Ligament Reconstruction.’ Operative Techniques in Sports Medicine, vol. 3(3), pp. 187-205.

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