ACL Reconstruction with Allografts and LARS Ligaments
Ligaments are tough, non-stretchable fibers that connect bones together in the body.
The knee, comprised of the femur, tibia, and patella, is a compound joint capable of movement in multiple planes. The articulation of the femur and tibia permits flexion, extension, and a small amount of rotation. A complex array of ligaments provides stability to the knee joint during these movements.
The anterior cruciate ligament (ACL) is one of the the major stabilizing ligaments of the knee. The ACL is located in the centre of the knee joint and runs from the femur (thigh bone) to the tibia (shin bone). The ACL prevents the femur from sliding backwards on the tibia (or the tibia moving forwards relative to the femur). Together with the posterior cruciate ligament (PCL), the ACL stabilizes the knee in rotation. When the ACL is torn, the knee becomes unstable in rotation, and susceptible to further injury. Recurrent giving way of the knee is common in the ACL damaged knee.
The ACL is the most commonly injured ligament in the knee. When the ligament is torn it generally does not heal on its own. The ACL can be injured in several ways:
- Changing direction rapidly
- Slowing down when running
- Landing from a jump
- Direct contact, such as in a football tackle
Successful ACL reconstruction surgery tightens your knee and restores its stability. It also helps you avoid further injury and get back to playing sports. Also important in the decision about treatment is that long term instability may lead to early arthritis of the knee.
ACL Reconstruction with Allografts
For patients that are unsuitable for hamstring or patellar tendon ACL reconstructions, allografts can be a good choice. Allografts are sourced from deceased donors through the NSW, Queensland or Perth bone and tissue banks. Allografts are specially sterilised and treated to prevent graft to host disease transmission and rejection. They are essentially collagen scaffolds with no cellular material remaining and are therefore not subject to rejection by the immune system. Anti-rejection drugs are therefore not required.
Allograft ACL reconstruction is a proven method that avoids the issues associated with hamstring and patellar donor site harvest.
ACL reconstruction with LARS ligaments
LARS ligaments are artificial ligaments intended for the intra or extra-articular reconstruction of ruptured ligaments. Designed to mimic the normal anatomic ligament fibers, the intra-articular longitudinal fibers resist fatigue and allow fibroblastic growth. The extra-articular woven fibers provide strength and resistance to elongation.
LARS ligaments can be used in conjunction with suturing to the remnant of the ruptured ligament, or as an autogenous reconstruction.
LARS ligaments can be used to reconstruct both the anterior and posterior cruciate ligaments, as well as other ligaments around the knee. LARS ACL and PCL ligaments come in many different sizes so that selection according to weight and activity can be precise.
The LARS ACL has the intra-articular bundles in clockwise or anticlockwise orientation; this is to mimic the natural ligaments in the right or left knee. It can be used in acute injuries or where there is a good ACL stump that has a good blood supply.
Allograft and LARS reconstructions have a shorter rehab time than hamstring or patellar tendon ACL reconstructions.
LARS ACL reconstruction and augmentation
Luke Covell’s Return To Rugby League
Luke Covell’s final home game after LARS surgery
LARS in the media
- Shark back as forward
- Luke Covell passes test on new knee (The Daily Telegraph)
- Luke Covell passes test on new knee (Couriermail.com.au)
- Miracle op to melt down surgeons’ phones
- Covell set for remarkable return
- Luke Covell’s career on knife’s edge
- How Luke Covell defied medical convention
- Luke Covell eyeing early return
- Luke Covell set for remarkable return from ACL injury