Ligament reconstruction with the LARS ligament has been a popular choice owing to its low-complication rates compared with previously commercially available grafts. The non-active nature of the implant also meant that there were no foreign body reactions that had been described with other synthetic grafts. We describe the first reported case of a granulomatous foreign body reaction in a LARS ligament Achilles tendon graft and a technique to reconstruct the tendon following its excision.