Abstract: BACKGROUND: The type of graft selected during anterior cruciate ligament revision is considered one of the main factors affecting the postoperative outcome, but there are few reports on the comparison between different graft materials.
OBJECTIVE: To explore the medium-to-long-term clinical efficacy after anterior cruciate ligament revision with autologous ligament, allogeneic ligament, and LARS artificial ligament. 
METHODS: A total of 67 patients with the first anterior cruciate ligament revision admitted to the Department of Joint and Sports Medicine, The Second Hospital of Tangshan from May 2011 to May 2020 were selected, including 41 males and 26 females, with a mean age of (45.83±7.39) years. They were divided into three groups according to different grafts used: autologous ligament group (n=24), allogeneic ligament group (n=22), and LARS artificial ligament group (n=21). Follow-up for more than 36 months after revision was performed to evaluate the effect of revision. 
RESULTS AND CONCLUSION: (1) International Knee Documentation Committee (IKDC) score, Lysholm knee score, and Tegner motor score 1 year after surgery and at the last follow-up in the three groups were higher than those before surgery (P < 0.05). There were no significant differences in IKDC score, Lysholm knee score, and Tegner motor score among the three groups 1 year after surgery and the last follow-up (P > 0.05). (2) The lateral differences of KT-1000 at 1 year after surgery and the last follow-up among the three groups were lower than those before surgery (P < 0.05). The lateral difference of KT-1000 and the positive rate of the axial shift test in the last follow-up of the LARS artificial ligament group were higher than those in the autologous ligament group and allogeneic ligament group (P < 0.05). (3) At the last follow-up, X-ray films showed no obvious enlargement of the reconstructed bone tunnel and no obvious failure of the graft fixation device. There was no obvious aggravation of osteoarthritis, but bone density decreased significantly in some elderly patients. (4) These findings suggest that anterior cruciate ligament revision with LARS artificial ligaments can obtain good initial stability, but with the extension of time, the stability of partial cases tends to decrease, even with reconstructed ligament failure. Both allogeneic and autogenous ligaments can obtain good clinical efficacy in anterior cruciate ligament revision.

Key words: anterior cruciate ligament reconstruction, revision, graft, allogeneic ligament, LARS artificial ligament, arthroscope