Purpose
To assess the mid-term clinical outcomes in patients with proximal avulsion anterior
cruciate ligament (ACL) tears undergoing arthroscopic primary repair with suture anchors.
Methods
The first 11 consecutive patients with proximal avulsion tears treated with arthroscopic
primary repair were evaluated at mid-term (minimum 5-year) follow-up. Physical examination
was performed; laxity examination consisting of the Lachman, pivot-shift, and anterior
drawer tests was performed; and patients were asked to complete the Lysholm, modified
Cincinnati, Single Assessment Numeric Evaluation, and International Knee Documentation
Committee (IKDC) questionnaires.
Results
Of the 11 patients, 10 were seen at a mean follow-up of 6.0 ± 1.5 years (range, 4.8-9.2 years).
One patient was lost to follow-up, in whom failure had already occurred at short-term
follow-up. One additional patient underwent reoperation for a medial meniscus tear
and also had a partial ACL tear; this patient was clinically stable at last follow-up.
All patients had full range of motion. Nine patients had negative Lachman and negative
pivot-shift examination findings (IKDC score of A), and 1 patient had a 1A Lachman
result and 1+ pivot-shift result (IKDC score of B). The mean Lysholm score was 96.0
± 4.5 (range, 88-100); modified Cincinnati score, 95.6 ± 7.4 (range, 80-100); Single
Assessment Numeric Evaluation score, 95.4 ± 5.4 (range, 85-100); preinjury Tegner
score, 7.2 ± 1.2 (range, 5-9); postoperative Tegner score, 6.6 ± 1.8 (range, 3-9);
and IKDC subjective score, 92.3 ± 11.3 (range, 64-100).
Conclusions
The clinical outcomes of arthroscopic primary repair of proximal ACL tears with suture
anchors are excellent and are maintained at mid-term follow-up in a carefully selected
subset of patients with proximal tears and excellent tissue quality.
Level of Evidence
Level IV, therapeutic case series.
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Article info
Publication history
Published online: January 18, 2018
Accepted:
October 10,
2017
Received:
April 24,
2017
Footnotes
The authors report the following potential conflict of interest or source of funding: G.S.D. receives support from Arthrex. Research grant. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Identification
Copyright
© 2017 Published by Elsevier on behalf of the Arthroscopy Association of North America
