I ruptured my left ACL in a skiing accident just over two months ago, and have my initial consult with an OS next week. I'm about 95% certain at this point that I'll be going for a hamstring autograft for my reconstruction, but I've recently been hearing a bit about LARS synthetic ligaments and am curious to find out more.
The background: I have a long history of knee problems, including natural hypermobility, mild osteoarthritis and severe bilateral PFS (chronic pain caused by kneecap tracking problems). The PFS makes me a very poor candidate for a patellar tendon graft. The natural hypermobility increases the risk of stretching a hamstring graft before it establishes a blood supply, leading to a lax or failed graft. It's been suggested by my family doctor (not a knee expert) that I should consider a synthetic ligament because it would eliminate this increased risk of graft failure.
Having heard this I immediately went and researched the hell out of synthetic ligaments, which gave me the following information:
- Synthetic ligaments used in the 80s were disastrous, with a very high instance of severe complications
- There's currently a new generation of synthetic ligaments (LARS), which don't exhibit these complications
- Many pro athletes are opting for these ligaments because of the rapid recovery time
- LARS ligaments are not FDA approved in the US, but are available in Canada (where I am) and Europe
- 5-year studies show a very good strength and success rate for LARS ligaments
- Because they're relatively new, there are no longitudinal studies indicating, say, 10-year outcomes
Clearly there are some advantages to these synthetic ligaments. I'm much less concerned about the rapid recovery than I am about long-term prognosis; I'd rather lose a ski season (or even two) now and know that I'd have another 20 good seasons ahead of me than go for a short-term fix just to get back on the slopes for 2010/11. My concern is more around the risk of graft failure caused by my natural hypermobility. However, that last point on the list - the lack of knowledge about long-term outcomes - is a huge issue.
I'm going to talk all of this over with my OS next week, and see what he has to say. In the meantime, I'm really curious to hear from any skiers who've opted for LARS ligaments (or who know anyone who has) and what they have to say about it as a graft choice.
Thanks in advance to anyone willing to share their experience.
Edited by kcxd - 5/11/10 at 10:38pm