As a moderator I have to ask you to be careful what you say. Please tone it down.
There was a very interesting article about the LARS technique in yesterday's age. A lot of AFL clubs are not prepared to take the risk with this procedure.
I had a reco using LARS a week and a half ago. I was up and on it in 4 days, no brace either ! So far I recomend it. I have had the other knee reco'ed 13 years ago using the patella tendon graft. I feel heaps better this time, because there is no extra damage by using hammy or patella.
oh also, I after the reco 13 years ago, I continued to play basketball, at an A grade level up until now. I had no problems with the patella graft. I was interested in getting the LARS reco done jst for the quick recovery time.
I am also a golfer and tradie so I will keep you updated over the next few weeks on how the knee performs on the job and on the course !!!
This is actually my second reco as I tore the ACL in my left leg 8 years ago and had the traditional patella reco on that one and just recently tore the ACL in the right, and opted for the new LARS method. Thus, whilst still not claiming to be an expert on the subject, I now have had both methods and can compare, although I am only at early days into the LARS recovery.
In terms of recovery and overall impact on knee and life in general, there is obviously no denying at this early stage that the LARS is the better option - but I don?t think anyone is disagreeing with this as, its the LARS speed of recovery that is it whole feature. I remember with the traditional method I was on crutches for 3 weeks, whereas with LARS I was load bearing after 3 days. The muscle atrophy is significantly less as the knee, and leg in general is out of action for a significantly less time, my ROM is also very good now whereas Patella reco took weeks and weeks for 90degree flexion.
Having said that, the whole issue with LARS is obviously the lack of experience and testimony as this new material has only been tried with success for a few years now. And although it seems with good success, has not existed long enough for the industry to deem it effective, which makes sense.
Unfortunately when I researched all this before opting for LARS, the only negative opinions on LARS were from people who opted for the traditional surgery and commented on the risks - which no doubt are there and hadn?t actually had LARS, rather opted against it. However, the positive opinions of LARS were actually from those people who had personally had the procedure and I found little evidence from these individuals that it was anything less than successful.
I play a considerably high level of sport (thus my many injuries) and occasionally from time to time I experienced general soreness around the patella site of my previously injured left leg when I had increased training. So my decision wasn?t only one of speed of return to sport, but also considering the issue that if in time the procedure remains successful, you are not robbing from one part of the body to help another, thus adding to the strain and work load of the newly robbed area.
Having said all that, as my surgeon said to me, either option is a good option depending on the individual. The traditional method is tried and tested and with a very high success rate - and personally after 8 years with a patella reco and 6 nights a week of training I can testify that the traditional method gave me no issues. However, my thoughts were, if surgeons of reputable stature are now doing this method, routinely, and after 2 years now, with no problem and for all early accounts, seem to have no negative except for lack of history - I could hardly forgo the option when it all sounded and seemed to be technically sound.
We have to remember in our lucky politically correct and to the T country, procedures, medicines, methods or actions of the medical community will never get across the line if they carry excessive risks or problems.
Anyway, would be more than happy to stay in touch with others moving through their recovery of the LARS method. Good to have a contact whether we all rise to great heights and the method becomes universally approved and revered or whether we all spontaneously combust in 10 years in when our grafts fall apart.
Good luck to all those going through the same decision.
Thanks for your post Kneegal,
I agree with your sentiments entirely.
I've recently been to my LARS post-op six monthly checkup and have passed with flying colours. My knee now feels "normal" with no pain or aggrevations and I am back to doing all the activities I enjoyed before, mainly working in the fitness industry & social sports. Not a high degree of atheticism needed from me but quality of life is just great again.
I am 100% happy with the result I achieved from the LARs procedure. For anyone considering LARs, investigate it thoroughly with your surgeon and don't always believe the hype you read in the papers.
Well I had a full patella-ACL reconstruction and meniscus repair October '07. I initially injured it playing football, after having not missed a game for 11 years. Made a full comeback this year (after 18 months off), my knee was feeling great and I would have said patella was the way to go, then in my 3rd game back I copped a heavy knock side on and tore 50% of my acl.
Was extremely shattering considering I'd done the full rehab and a full preseason to get to where I was. I met with my surgeon today and we both agreed on the LARS method. He said he had done 65 of them previously so it's good to know I'm not going to be his guinny pig.
Better still after I get it done on Monday week, he said I could be back playing this season 6 weeks after the op. I think had it been a full tear the recovery would be longer such as the 3 months Malceski had off. But because there is almost 50% of the fibres still attached in my existing acl he said only 6 weeks. So pretty over the moon.
The patella reco was solid, and I think had anyone been hit in the knee the same angle I was the second time, they would have torn their acl.
Having the opportunity to get back out on the field in 7 weeks from now, as opposed to 12-18 months, I think is amazing.
Risky? Perhaps, but you would have to be extremely unlucky from all reports to have a problem with it. From what I have read it appears to be no riskier than any other graft, aside from the fact it hasn't been around long enough to see the long term effects. But as long as it can give me 10 years more of footy i'll be happy (currently 20 yrs old).
If anyone else out there has had the LARS graft, and made a comeback to high contact sport, it would be good to hear how speedy your recovery was, and any issues you encountered. Cheers, Pete.
It is great if the LARS technique has helped you all, but is not suitable for everyone.
Very interesting that both Geelong with Josh Hunt and Essendon with David Hille have decided to opt for the traditional technique as it has more success. It is obviously still considered to be too risky and not enough experience with it yet.
The technique is still banned in France.
Yes the patella is definately still the 'traditional gold standard' from many of Melbourne's top surgeons, and the most proven. A lot of them such as Julian Feller don't say that the LARS technology is bad, but rather there has not been enough performed yet to be 100% confident that it will be successful in the long run. Julian Feller did say though that he would "probably be performing them within the next couple of years" after continued study on the new graft (he told one of my footy mates this who he performed a patella reco on a few weeks ago).
From looking around there is not enough evidence to confidently argue for or against. There has been obvious success with it (Nick Malceski), I would like to hear specific cases of LARS failing though, as there isn't a whole lot of case examples out there.