Abstract
Background: Anterior cruciate ligament (ACL) injuries are common in athletes, but their prevalence has also increased among adults. ACL reconstruction (ACLR) is a key treatment option, with graft choice playing a critical role in recovery. The study evaluates the clinical and functional outcomes of ACLR using the Ligament Augmentation and Reconstruction System (LARS) in patients over 35 years old. It assesses implant survival, failure rate, and revision rate, and measures quality of life and subjective outcomes. Methods: Fifty-three patients were finally included in this retrospective two-center study. The study assessed quality of life (QoL) and subjective outcomes using IKDC and Lysholm scores, evaluated implant survival and revision rates, and assessed the difference in activity levels between the two years before ACL injury and at follow-up. Results: The study found high Lysholm (90.61) and IKDC (80.25) scores, indicating positive clinical results. However, about 40% of patients did not return to their pre-injury activity levels. The graft failure rate was low at 3.8%, with no cases of infection or implant rejection. Conclusions: The study concluded that LARS ACLR is an effective option for middle-aged patients, offering faster recovery and fewer complications. However, it may not be suitable for younger, professional athletes due to its mechanical limitations. Further research with larger sample sizes and longer follow-up is recommended.