Purpose
To evaluate clinical outcomes and patient-reported outcomes of patients who underwent
primary anterior cruciate ligament (ACL) repair using suture tape augmentation.
Methods
Patients with a proximal tear of the ACL who underwent primary ACL repair with a minimum
2-year follow-up were included. The exclusion criteria included multiligamentous knee
injuries, midsubstance tears, tibial avulsion fractures, and distal tears. Demographic
characteristics, injury pattern, concomitant injury pattern, and patient-reported
outcome measures were recorded. Patients were evaluated at a minimum 2-year follow-up
for clinical success, defined as stability not requiring revision ACL reconstruction,
and for patient-reported outcome measurements. Failure was defined as the need for
revision surgery.
Results
The mean follow-up period was 2.8 ± 0.9 years. Thirty-five patients met the inclusion
criteria, with an average age of 32.2 ± 7.2 years, and 2-year follow-up was obtained
for 29 of these patients. Revision surgery was required in 2 of the 29 patients (6.9%);
successful treatment was achieved in the remaining 93.1%. The Single Assessment Numeric
Evaluation score and Knee Injury and Osteoarthritis Outcome Score for the 27 successfully
treated patients were recorded, with 70.4% having Single Assessment Numeric Evaluation
scores of 80 or greater.
Conclusions
This case series shows that primary surgical repair of proximal ACL tears using suture
tape augmentation results in a low rate of revision surgery.
Level of Evidence
Level IV, prospective case series.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to ArthroscopyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Primary repair of the anterior cruciate ligament: A systematic review.Arthroscopy. 2015; 31: 2233-2247
- Primary repair of the anterior cruciate ligament: A paradigm shift.Surgeon. 2017; 15: 161-168
- Isolated tear of the anterior cruciate ligament: 5-Year follow-up study.Am J Sports Med. 1976; 4: 95-100
- Primary surgical treatment of anterior cruciate ligament ruptures. A long-term follow-up study.Am J Sports Med. 1990; 18: 354-358
- The long-term followup of primary anterior cruciate ligament repair. Defining a rationale for augmentation.Am J Sports Med. 1991; 19: 243-255
- Arthroscopic primary repair of proximal anterior cruciate ligament tears seems safe but higher level of evidence is needed: A systematic review and meta-analysis of recent literature.Knee Surg Sports Traumatol Arthrosc. 2020; 28: 1946-1957
- Long-term follow-up after primary repair of the anterior cruciate ligament: Clinical and radiological evaluation 15-23 years postoperatively.Arch Orthop Trauma Surg. 2005; 125: 217-221
- Isolated tears of the anterior cruciate ligament: Over 30-year follow-up of patients treated with arthrotomy and primary repair.Am J Sports Med. 2009; 37: 65-71
- Accelerated rehabilitation after anterior cruciate ligament reconstruction.J Orthop Sports Phys Ther. 1992; 15: 256-264
- Anterior cruciate ligament repair with internal brace ligament augmentation.Surg Technol Int. 2016; 29: 273-278
- Use of a bioactive scaffold to stimulate anterior cruciate ligament healing also minimizes posttraumatic osteoarthritis after surgery.Am J Sports Med. 2013; 41: 1762-1770
- Differences among mechanoreceptors in healthy and injured anterior cruciate ligaments and their clinical importance.Muscles Ligaments Tendons J. 2012; 2: 38-43
- Proprioception and function after anterior cruciate reconstruction.J Bone Joint Surg Br. 1991; 73: 833-837
- ACL reconstruction: A meta-analysis of functional scores.Clin Orthop Relat Res. 2007; 458: 180-187
- High rates of osteoarthritis develop after anterior cruciate ligament surgery: An analysis of 4108 patients.Am J Sports Med. 2018; 46: 2011-2019
- Complications of anterior cruciate ligament reconstruction with bone-patellar tendon-bone constructs: Care and prevention.Am J Sports Med. 2008; 36: 379-394
- Tunnel widening in single- versus double-bundle anterior cruciate ligament reconstructed knees.Knee Surg Sports Traumatol Arthrosc. 2017; 25: 1316-1327
- Outcomes of repeat revision anterior cruciate ligament reconstruction.Am J Sports Med. 2013; 41: 1296-1301
- Range of motion and complications following primary repair versus reconstruction of the anterior cruciate ligament.Knee. 2017; 24: 798-807
- Arthroscopic primary anterior cruciate ligament repair with suture augmentation.Arthrosc Tech. 2017; 6: e1529-e1534
- Anterior cruciate ligament preservation: Early results of a novel arthroscopic technique for suture anchor primary anterior cruciate ligament repair.Arthroscopy. 2015; 31: 2162-2171
- Primary arthroscopic repair of the anterior cruciate ligament: A systematic review of clinical outcomes.Arthroscopy. 2019; 35: 3318-3327
- Acute proximal anterior cruciate ligament tears: Outcomes after arthroscopic suture anchor repair versus anatomic single-bundle reconstruction.Arthroscopy. 2016; 32: 2562-2569
- Knee Injury and Osteoarthritis Outcome Score (KOOS): Systematic review and meta-analysis of measurement properties.Osteoarthritis Cartilage. 2016; 24: 1317-1329
- Knee Injury and Osteoarthritis Outcome Score (KOOS)—Development of a self-administered outcome measure.J Orthop Sports Phys Ther. 1998; 28: 88-96
- Defining thresholds for the patient acceptable symptom state for the IKDC subjective knee form and KOOS for patients who underwent ACL reconstruction.Am J Sports Med. 2016; 44: 2820-2826
- Mechanoreceptors in the anterior cruciate ligament contribute to the joint position sense.Acta Orthop Scand. 2002; 73: 330-334
- Current status and potential of primary ACL repair.Clin Sports Med. 2009; 28: 51-61
- Dynamic intraligamentary stabilization (DIS) for treatment of acute anterior cruciate ligament ruptures: Case series experience of the first three years.BMC Musculoskelet Dis. 2015; 16: 27
- Arterial supply to the human anterior cruciate ligament.J Athletic Train. 1995; 30: 149-152
- Role of tear location on outcomes of open primary repair of the anterior cruciate ligament: A systematic review of historical studies.Knee. 2017; 24: 898-908
- Is there a role for internal bracing and repair of the anterior cruciate ligament? A systematic literature review.Am J Sports Med. 2018; 46: 2291-2298
- Improved results of ACL primary repair in one-part tears with intact synovial coverage.Knee Surg Sports Traumatol Arthrosc. 2019; 27: 37-43
- Primary knee ligament repair—Revisited.Clin Orthop Relat Res. 1985; 199: 185-191
- Die frische gerade vordere Knieinstabilität. 2-5 Jahresergebnisse der operative Behandlung [Acute uncomplicated anterior knee instability. 2-5 year follow-up of surgical treatment].Unfallchirurg. 1991; 94 ([in German]): 81-87
- Factors influencing the success of anterior cruciate ligament repair with dynamic intraligamentary stabilisation.Knee Surg Sports Traumatol Arthrosc. 2017; 25: 3923-3928
- Intrinsic healing response of the human anterior cruciate ligament: An histological study of reattached ACL remnants.J Orthop Res. 2014; 32: 296-301
- Primary repair of the anterior cruciate ligament.Clin Sports Med. 1988; 7: 739-750
- Bio-enhanced repair of the anterior cruciate ligament.Arthroscopy. 2015; 31: 990-997
- Patients forget about their operated knee more following arthroscopic primary repair of the anterior cruciate ligament than following reconstruction.Arthroscopy. 2020; 36: 797-804
- Arthroscopic primary repair of proximal anterior cruciate ligament tears: Outcomes of the first 56 consecutive patients and the role of additional internal bracing.Knee Surg Sports Traumatol Arthrosc. 2019; 27: 21-28
- Bone-to-bone fixation enhances functional healing of the porcine anterior cruciate ligament using a collagen-platelet composite.Arthroscopy. 2010; 26: S49-S57
- Histological evaluation of the healing potential of the anterior cruciate ligament by means of augmented and non-augmented repair: An in vivo animal study.Knee Surg Sports Traumatol Arthrosc. 2008; 16: 1087-1093
- Biomechanical evaluation of augmented and nonaugmented primary repair of the anterior cruciate ligament: An in vivo animal study.Int Orthop. 2013; 37: 2305-2311
- Evaluation of bone tunnel placement for suture augmentation of an injured anterior cruciate ligament: Effects on joint stability in a goat model.J Orthop Res. 2010; 28: 1373-1379
- Suture augmentation following ACL injury to restore the function of the ACL, MCL, and medial meniscus in the goat stifle joint.J Biomech. 2011; 44: 1530-1535
- Clinical outcomes of arthroscopic primary repair of proximal anterior cruciate ligament tears are maintained at mid-term follow-up.Arthroscopy. 2018; 34: 1085-1093
- Anterior cruciate ligament retensioning—A novel revision procedure using suture augmentation: A case report with a 3-year follow-up.JBJS Case Connect. 2020; 10e0092
- Patient-reported outcomes to support medical product labeling claims: FDA perspective.Value Health. 2007; 10: S125-S137
- A systematic review of long-term patient reported outcomes for the treatment of anterior cruciate ligament injuries in the skeletally immature.J Child Orthop. 2018; 12: 251-261
Article info
Publication history
Published online: February 09, 2021
Accepted:
November 6,
2020
Received:
April 5,
2020
Footnotes
See commentary on page 1242
The authors report the following potential conflicts of interest or sources of funding: E.H.A. receives personal fees from Arthrex, KCI, and OrthAlign, outside the submitted work. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Identification
Copyright
© 2021 by the Arthroscopy Association of North America
