Summary

Primary ACL repair with DIS leads to clinically stable healing of the torn ACL in a majority of patients, with a 3-year survival rate of 82%. Patients with a clinically healed ACL showed satisfactory to excellent outcome scores and function at mid-term follow up.

Abstract

Introduction

In recent years, renewed interest came up for primary ACL repair in ACL reconstruction surgery. The purpose of this study was to evaluate the mid-term results on 38 cases.

Materials And Methods

38 consecutive patients (twenty-six males, twelve females) were allocated to this study and underwent surgery between August 2013 and March 2016. Inclusion criteria were an ACL rupture not older than 14 days, patient age <45 years and no previous surgery on the injured knee. Treatment of the ACL tear was performed by using DIS, which acted as an internal stabilizer to keep the unstable knee in posterior translation to allow self-healing. Patient outcome and survival rate were evaluated using a clinical assessment (VAS, Lysholm, Tegner, IKDC) and evaluation of knee laxity (clinically and by laximetry) was performed at 6 weeks and 6, 12, 24 and 36 months.

Results

Average age at time of surgery was 31 years, with a mean of 13 days to surgery. Postoperative VAS score at 6 weeks was 7.3, with 9.3 at 3 years of follow up. Early postoperative mean Lysholm and IDKC scores were 64.8 and 49.0, respectively. At 3 year follow up, mean Lysholm and IKDC scores were 96.0 and 90.1. At 2 years postoperatively, a Tegner score of 6 was noted. All clinical outcome scores improved significantly. Antero-posterior and rotational stability was evaluated using clinical examination and laximetry, showing a large inter-patient variability, with an increase in rotational motion of 2-4°, not significantly differing from the non-operated side. On clinical examination, we saw an increasing grade of pivot-shift over the period of follow-up. On survival analysis, 82% survival at 36 months was seen.

Conclusions

Primary ACL repair with DIS leads to clinically stable healing of the torn ACL in a majority of patients, with a 3-year survival rate of 82%. Patients with a clinically healed ACL showed satisfactory to excellent outcome scores and function at mid-term follow up.