Surgical Reconstructions for Posterolateral Rotatory Instability of Elbow using a Synthetic Ligament

Background Chronic posterolateral rotatory instability occurs as a result of disruption of the lateral ulnar collateral ligament of the elbow. It is usually treated by ligament reconstruction using an autogenous graft. We present our experience of reconstruction with the use of a synthetic polyester (LARS®; Ligament Advanced Reinforcement System; Surgical Implants and Devices, Arc-sur-Tille, France) ligament and discuss the advantages of this technique. Methods Ten consecutive cases of lateral ligament reconstruction using a LARS® ligament were reviewed. The mean age at the time of surgery was 30.2 years. The mean duration of instability symptoms preoperatively was 32.4 months. Three patients had generalized hyperlaxity. Three patients had previously undergone an unsuccessful autogenous graft reconstruction. Results The mean postoperative follow-up was 27 months. At review, seven of the 10 patients had stable elbows with no feelings of recurrent instability. This included two of the patients with generalized hyperlaxity. The mean postoperative arc of flexion/extension was 13° to 137°. The mean Mayo Elbow Performance Score was 87.5. Conclusions The use of a synthetic ligament for reconstruction of posterolateral rotatory instability of the elbow provides satisfactory stability. It avoids the associated morbidity of using an autograft, appears to be well tolerated and is particularly valuable in the treatment of complex generalized hyperlaxity problems.