Soft Tissue Internal Fixation

Operative Techniques

STIF can be used for extra-articular reconstructions in tendon repair, such as Achilles tendon, patella tendon, biceps tendon, etc. These ligaments must always be placed in the joint in an anatomical and isometric position. The diameter of the bony tunnels must correspond to the specific reference for each type of ligament which as a general rule should be as small as possible.

The fixation of the ligament extremities must always be extra-articular.

Biological and mechanical testing on resistance, fatigue and creep have shown that STIF ligaments are highly effective ligament reconstruction and augmentation devices. The use of the STIF artificial ligament requires a specific surgical technique, for which dedicated STIF instruments are available.

Implantation Method. A number of guidelines must be respected:

  • Isometry is critical to the outcome
  • Acute angles must be avoided in the drilling of the bony tunnels
  • There must be no impingement or abrasion of the ligament in the joint
  • Solid extra-articular fixation must be achieved using STIF interference screws
  • Absence of tension in the synthetic ligament is important; the post-operative tension should not be more than that of the anatomical ligament being repaired
  • Coverage by fibrous tissue is desirable
  • Small incisions should be used to retain proprioception.

Clinical Papers

Yushaobin - 2009120124958

Rabbit test

Comparative study of the fatigue behaviour

Mechanical studies

Evaluation fixation ligt pour LCA H. Yahia

Mechanical Testing of a Synthetic Canine Gastrocnemius Tendon Implant

Repair of chronic rupture of the insertion of the gastrocnemius tendon in the dog using a polyethylene terephthalate implant

Gastrocnemius Tendon Repair with Vetlig CAT30 video operative technique

Knee (ACL) - studies and papers

Gao, K. et al. (2010). Anterior Cruciate Ligament Reconstruction With LARS Artificial Ligament: A Multicenter Study With 3- to 5-Year Follow-up. Arthroscopy. The Journal of Arthroscopic and Related Surgery, Vol 26, No 4 (April), 2010: pp 515-523 R

Hamido, F. et al. (2010). The use of the LARS artificial ligament to augment a short or undersized ACL hamstrings tendon graft. The Knee, November. [Epub ahead of print]

Zhong-tang Liu (2009). Four-strand hamstring tendon autograft versus LARS artificial ligament for anterior cruciate ligament reconstruction. International Orthopedics, 2009 Apr 25. [Epub ahead of print]

Fan, Q. et al. (2008). Comparison between four-strand semitendinosus tendon autograft and ligament advanced reinforcement system for anterior cruciate ligament reconstruction by arthroscopy. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2008 Jun;22(6):676-9. P

Khalaf, W.A (2008). Patients satisfaction after arthroscopic ACL reconstruction using the LARS artificial ligament. Available from:

Cerulli, G. et al. (2007). ACL reconstruction using artificial ligaments: Five years follow-up. S.I.O.T, 33 (3suppl. 1), pp. 8238-8242 R

Nau, T. et al. (2002). A new generation of artificial ligaments in reconstruction of the anterior cruciate ligament. Blinded prospective randomised study. JBJS (Br), Vol 84b (3), pp. 356-360 RCT

Lavoie, P. et al. (2000). Patient satisfaction needs as related to knee stability and objective findings after ACL reconstruction using LARS artificial ligament. The Knee, 7, pp. 157-163 C

Laboureau (1997). Symposium International de Biomatériaux Avancés (SIBA). The use of the free fibers LARS ligament in acute anterior cruciate ligament repairs

Derricks G. (1995). LARS anterior cruciate ligament reconstruction, Operative Techniques in Sports Medicine, 3(3): 187-205. C

Knee (PCL) - studies and papers

Boisrenoult, P. et al. (2010). Reconstruction of acute posterior cruciate ligament tears using a synthetic ligament: 45 cases at five years mean follow-up. P14 - Posters: Knee - PCL (P14-1155). 14th ESSKA Congress, June 9-12, 2010, Oslo, Norway

Shen, G. et al.(2010). Arthroscopic Posterior Cruciate Ligament Reconstruction Using LARS Artificial Ligament: A Retrospective Study. J Surg Res. 2010 Sep 8. [Epub ahead of print]

Li P (2008). Arthroscopic single-bundle posterior cruciate ligament reconstruction: retrospective review of hamstring tendon graft versus LARS artificial ligament.International Orthopedics, Jul: 25, R

Brunet, P. (2005). [Reconstruction of acute posterior cruciate ligament tears using a synthetic ligament]. Rev Chir Orthop Reparatrice Appar Mot, 2005; 91(1):34-43 C

Laboureau J.P. (2002). 10 year follow up of Acute PCL repair.SICOT Meeting - San Diego, USA.Laboureau J.P. (2002). 10 year follow up of Acute PCL repair.SICOT Meeting - San Diego, USA.

Johnson D. et al (2001). Cruciate Ligament reconstruction with Synthetics (Chap.) In Gregory C. Fanelli (2001 Ed.): Posterior Cruciate Ligament Injuries: A Practical Guide to Management, New York: Springer-Verlag, pp.189-214.

Laboureau, J.P (2001). Reconstruction of posterior cruciate ligament rupture and posterolateral instability with synthetic ligaments. Editions Scientifiques et Medicales Elsevier SAS (Paris). Surgical Techniques in Orthopaedics and Traumatology, 2001: 55-540-C-20. C

Teule et al. (2000). Posterior Cruciate Ligament Reconstruction: The Role of Synthetic Ligaments.Riv Lt Biol Med 20. C

Knee (various) - studies and papers

Naim S. et al. (2011). Patellar tendon reconstruction using LARS ligament: surgical technique and case report. Strategies Trauma Limb Reconstr. 2011 Apr;6(1):39-41. Epub 2011 Jan 14.

Huang, J. et al. (2010). Cruciate ligament reconstruction using LARS artificial ligament under arthroscopy: 81 cases report. Chin Med J 2010;123(2):160-164 C

Ranger (2010). Evaluation of reconstructive surgery using artificial ligaments in 71 acute knee dislocations

Ibrahim, S.A. et al. (2008). Surgical management of traumatic knee dislocation.Arthroscopy 24(2), pp.178-187. C

Ranger, P. (2008) .Treatment of acute dislocations using synthetic ligaments. Journal of Bone and Joint Surgery - British Volume, Vol 90-B, Issue SUPP_I, 113 . C

Dominikus, M. et al. (2006). Reconstructing the Extensor Apparatus with a New Polyester Ligament. Clinical Orthopaedics and Related Research, 453, pp. 328-334 P

Talbot, M. (2004). Knee dislocations: Experience at the Hôpital du Sacré-Coeur de Montréal. Can J Surg. 2004 Feb;47(1):20-4.

Labbe, J.L. (1999). Acute bicruciate knee injury. New Zealand Orthopaedic Association. 48th Annual Scientific Meeting.

Shoulder - studies and papers

Fraschini G, et al. (2010). Surgical treatment of chronic acromioclavicular dislocation: Comparison between two surgical procedures for anatomic reconstruction. Injury. [Epub ahead of print]

Quinn, T. (2010). LARS Ligament Reconstruction for acromioclavicular joint dislocations - a clinical study. Accessed in July, 2010.

Krenn (2005). Biomechanical Analysis of Different Operative Techniques with complete ACJ disruption.Osteo Trauma Care, pp. 154-159. B

Fialka, C (2005). Biomechanical analysis of different operative techniques for complete acromioclavicular joint disruptions

Krenn M. Revolution in shoulder prosthetics: Permanent tendon replacement for RC defect. Non sense, alternative or a solution? Jatros Orthopedica 2005:5, 11-13

Fialka, C. et al. (2004). Traumatic ACJ separation. Current concept.European Surgery Journal, 20(24).

Roman et al. (2003). Our experience with LARS in massive rotator cuff tear, 44 cases. EuropeanCongress of Sport Traumatology, Monte Carlo, Monaco

Fialka, C. (2000). Preliminary results in ACJ dislocation using a LARS.Poster - ESSKA 2000 (Vienna)

Foot and ankle - studies and papers

Dhillon MS, et al. (2010). Reconstruction of bilateral spontaneous chronic idiopathic Achilles tendon rupture using LARS ligament: Case report. Foot (Edinb). 2010 Oct 21. [Epub ahead of print]

Ibrahim, S.A. et al. (2009). Surgical treatment of Chronic Achilles Tendon Rupture. The Journal of Foot and Ankle Surgery 49(3), pp. 340-347. R

Fletcher et al. (1997). Repair of Achilles tendon with a LARS . 1st Symposium of Biomaterial Advances, Montreal, Canada.

Hip - studies and papers

Bajwa, AS. (2011). Gluteal tendon reconstruction in association with hip arthroplasty. Hip Int. 2011 Jun 13;21(3):288-292

Simpson (2011). Arthroscopic Reconstruction of the Ligamentum Teres

Holroyd, B. & Fern, D.E. (2009). Synthetic Ligaments in Hip Surgery. European Musculoskeletal Review pp. 52-54 C

Holroyd, B. & Fern, D.E. (2008). A Novel use for Synthetic Ligaments in Hip Surgery. Annals Royal Collage of Surgery.90: pp. 253-259. C


Bernardino S (2010). ACL prosthesis - Any promise for the future? Knee Surg Sports Tramatol Arthrosc (2010) 18:797-804

Legnani (2010). Anterior cruciate ligament reconstruction with synthetic grafts. A review of literature

Chen J, Xu J, Wang A, Zheng M. Scaffolds for tendon and ligament repair: review of the efficacy of commercial products. Expert Rev Med Devices. 2009 Jan;6(1):61-73

Mascarenhas R, MacDonald PB. Anterior cruciate ligament reconstruction: a look at prosthetics - past, present and possible future. McGill Journal of Medicine 2008, 11(1): 29-37.

Laboratory studies and papers

Yu, S.B. et al. (2008). Histological characteristics of an ultrastructure of polyethelene terephthalate LARS ligament following the reconstruction of anterior crucate ligament in rabbits. Zhongguo Zuzhi Gongcheng Yanjiu yu Linchuang Kangfu. 2008;12(36):7061-7066

Trieb, K. et al. (2004). In vivo and in vitro cellular ingrowth into a new generation of artificial ligament. Eur Surg Res. May-Jun;36(3):148-51.

Hagemeister, N. et al (2002). Comparison of two methods for reconstruction of the posterior cruciate ligament using a computer based method: quantitative evaluation of laxity, three-dimensional kinematics and ligament deformation measurement in cadaver knees, The Knee, 9(4): 291-299.

Tabrizian M., et al. (1996)., Technical report: Evaluation of synthetic LARS knee ligaments, Biomechanics and Biomaterials Research Group, École Polytechnique de Montréal, pp.1-34.