| Objective:To discuss the LARS artificial ligament reconstruction anterior cruciate ligament(ACL) in patients with mid-term postoperative knee function and stability and bone(tibia,femur) tunnel enlargement by multi-targets assess;observation of artificial ligaments in human tissues in the form of changes in the morphologic of LARS artificial ligament for the future clinical application of scientific and effective to provide theoretical and technical support.Methods:Choose March 2004 to October 2008 the 57 cases treated(58 knees)(including two cases of initial construction surgery in other hospital) patients with anterior cruciate ligament injury,36 cases of male,21 cases of female;were diagnosed preoperative anterior cruciate ligament rupture, according to LARS artificial ligament using indications,combined with the recommendation of doctors and patients choose LARS artificial ligament reconstruction of ACL.28 cases of left knee,right knee in 30 cases(1 patient knees reconstruction at the same time) the average age is 30.2 years old.Patients divided into two groups according to acute or chronic injury (injury to surgery in 3 weeks as a dividing line,16 cases in acute gruop,42 cases in chronic,the longest 1.5 years) carried out a retrospective analysis of multiple indicators,follow-up period was 6-60 months,mean follow-up time on 40.6 months.Subjective and objective assessment of joint assessment:subjective assessment included Lysholm,Tegner,IKDC subjective score(Table 2-4). The objective assessment,including:physical examination of knee joint (Table 1),IKDC knee examination(Table 5),kt-2000 examination,and postoperative and follow-up X-ray(parts were MR) examination bone tunnel enlargement.Morphological detection:The three cases(4 knees) reoperation cases of artificial ligament material,check cross-section of the H.E.stained sections were observed in human soft tissue and artificial materials histocompatibility situation.Results:1.The 2 group's subjective knee score(Lysholm score,Tegner and IKDC score) compared no significant difference(P＞0.5).In-group's data were confirmed before and after operation,postoperative joint function,the level of knee joint movement was significantly higher than that preoperatively(P＜0.01).2.The two groups and no case of acute and chronic knee synovitis and synovial hypertrophy。3.Two of the objective assessment of knee function(IKDC knee examination,kt-2000 knee mobility instrument checks) no statistics significant differences(P＞0.5).4.Postoperative imaging examinations(X-ray and MR) showed varying degrees of bone tunnel enlargement and change with time,the enlargement unnels after an average duration of 1 years.Joint stability and the degree of bone tunnel expansion was no significant correlation(P＞0.5), two groups of bone tunnel expansion was no significant difference(P＞0.5),two groups ratio of tibial and femoral tunnel enlargement was no significant difference(P＞0.5).5.All and parts of the ligament rupture in the second operation in cases of material was observed after two years LARS artificial ligament and inner wall of bone tunnel the non-scarring,granulomatous rules with fibers into a single beam and into polyester fiber bundle fiber connection.Conclusion:1.LARS artificial ligament in anterior cruciate ligament reconstruction get recovery of function and stability.2.Penomenon of bone tunnel expansion,1.5 years later stabilized.Joint stability after the extent of bone tunnel expansion. 3 no significant correlation.Acute injury and chronic injury after the assessment was no significant difference comparison.4.LARS artificial ligament with human tissues have good tissue compatibility,human soft tissue fibers to the law of growth in artificial materials.
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