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LARS Ligament Reconstruction for acromioclavicular joint dislocations - a clinical study

Introduction: Traditional surgical reconstructions of acromioclavicular joint (ACJ) dislocations have failure rates of 15-25%. Most techniques are insufficiently robust or too stiff. The LARS ligament is both strong and non-rigid, with many biomechanical benefits.

Aims: The aim of this study was to assess the clinical and radiographic outcomes of reconstructions of ACJ dislocations using the LARS ligament.

Methods: Over a one year period, eleven patients (mean age, 40 yrs) underwent ACJ reconstruction with the LARS ligament. The mean follow-up period was 11.2 months.

Results:  Five patients underwent reconstruction within three months of injury. All were Rockwood type IV or V. Six patients were chronic, comprising one Type III injury, with the rest being Type IV and V.
The mean pre-op Oxford score was 40.14 (range 22-59) versus 17.00 (range 11-38) post-operatively (p = <0.05). The mean pre-op Constant score was 20.71 (range 8-61) versus 84.45 (range 61-92) post operatively (p = <0.05).
The mean satisfaction score was 85% (range 50-100). Seven patients returned to their previous level of sports and work activities, two returned to a reduced level and one returned to a significantly reduced level.
There was no difference in any of the outcomes between the acute and chronic reconstructions.
Realignment of the acromion and clavicle was achieved radiographically in all cases and maintained. No complications were seen.

Conclusion: AC joint reconstruction using the LARS ligament appears to be viable technique for the surgical reconstruction of AC Joint dislocations, both acutely and chronically.

KEYWORDS: acromioclavicular joint dislocation; LARS ligament, coracoclavicular reconstruction

Level of Evidence: Level IV.

Also See:

• LARS ligament
• LARS ligament Technique
• AC Joint Dislocations

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