Suture tape augmentation ACL repair, stable knee, and favorable PROMs, but a re-rupture rate of 11% within 2 years.

Autor: Heusdens CHW; Antwerp University Hospital, Orthopaedics, Drie Eikenstraat 655, 2650, Edegem, Belgium. Krik.Heusdens@uza.be., Blockhuys K; Antwerp University Hospital, Orthopaedics, Drie Eikenstraat 655, 2650, Edegem, Belgium., Roelant E; Antwerp University Hospital, Orthopaedics, Drie Eikenstraat 655, 2650, Edegem, Belgium.; University of Antwerp, Antwerp, Belgium., Dossche L; Antwerp University Hospital, Orthopaedics, Drie Eikenstraat 655, 2650, Edegem, Belgium., Van Glabbeek F; Antwerp University Hospital, Orthopaedics, Drie Eikenstraat 655, 2650, Edegem, Belgium.; University of Antwerp, Antwerp, Belgium., Van Dyck P; Antwerp University Hospital, Orthopaedics, Drie Eikenstraat 655, 2650, Edegem, Belgium.; University of Antwerp, Antwerp, Belgium.
Jazyk: angličtina
Zdroj: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA [Knee Surg Sports Traumatol Arthrosc] 2021 Nov; Vol. 29 (11), pp. 3706-3714. Date of Electronic Publication: 2021 Jan 02.
DOI: 10.1007/s00167-020-06399-2
Abstrakt: Purpose: The aim of this study is to investigate clinical and magnetic resonance imaging (MRI) outcomes after anterior cruciate ligament (ACL) repair using the suture tape augmentation (STA) technique.
Methods: This prospective interventional case series included 35 patients who underwent STA ACL repair and were all followed up for 2 years. The ACL rupture was between 4 and 12 weeks old and per-operatively confirmed repairable. The International Knee Documentation Committee (IKDC), and Lysholm and Tegner scores were collected together with return to work (RTW), return to sport (RTS), re-rupture, and re-intervention rate. Lachman testing was performed and ACL healing was evaluated on MRI using a grading scale based on the ACL's morphology and signal intensity with grade 1 representing good ACL healing and grade 3 representing poor ACL healing.
Results: The number of patients who returned to their pre-rupture level for IKDC, Lysholm, and Tegner scores at 2 years of follow-up are 17/26 (65.4%), 13/25 (52.0%), and 18/27 (66.7%) patients, respectively. Median RTW and RTS periods were 5.5 weeks (range 0-32 weeks) and 6 months (range 2-22 months), respectively. The Lachman side-to-side difference decreased significantly (P < 0.001) to less than 3 mm after surgery and remained stable. Four patients [11.4%, 95% CI (3.2, 26.7)] suffered from a re-rupture and three other patients [8.6%, 95% CI (1.8, 23.1)] needed a re-intervention for another reason than re-rupture. MRI follow-up of 31 patients showed overall grade 1 ACL healing in 14 (45.2%) patients, grade 2 ACL healing in 11 (35.5%) patients, and grade 3 ACL healing in 6 (19.4%) patients. A higher risk of re-rupture was associated with grade 3 ACL healing at 6 months post-operatively and a pre-operative Tegner score of  ≥  7.
Conclusion: This study shows that treatment of the acute, repairable ACL with the STA technique leads to a stable knee and favorable patient-reported outcome measures (PROMs). However, the re-rupture rate of 11.4% within the 2-year follow-up is a concern.
Level of Evidence: IV.
(© 2021. European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA).)
Databáze: MEDLINE
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