Summary: ACL repair yielded comparable functional outcome but increased rate of recurrent ACL insufficiency in relation to ACL reconstruction five years postoperatively in a randomized controlled trial.

Background

Recent studies have highlighted the fact that ACL repair can lead to satisfying functional results and healing rates in the short term. Aim of the present study was to compare the mid-term functional results after ACL repair in comparison to primary ACL reconstruction for acute isolated ACL tears. It was hypothesized, that ACL repair would yield comparable functional results, knee joint stability and recurrent instability rate in relation to ACL reconstruction.

Study design:
Prospective randomized Study; Level of evidence 1

Methods

85 patients with acute ACL tears were randomized to undergo either ACL repair using dynamic intraligamentary stabilization or primary ACL reconstruction with a semitendinosus autograft. The preinjury activity level and function were recorded. Short- and mid-term outcome was assessed at one, two and five years postoperatively. Anterior tibial translation (ATT) was evaluated by Rolimeter testing. Tegner activity scale, the International Knee Documentation Committee (IKDC) subjective score and the Lysholm score were acquired. Furthermore, the rate of recurrent instability and other complications were recorded.

Results

Follow-up rate was >80% in both study groups. Five years postoperatively Delta-ATT was 1.7 ± 1.6 mm in the ACL repair group and 1.4 ± 1.3 mm in the ACL reconstruction group (p = n.s.). In both groups, pre-injury knee function assessed by Tegner, Lysholm and IKDC score was restored as soon as one year after surgery and maintained until two and five years postoperatively. No significant difference in terms of patient reported outcome measures was found between ACL repair and ACL reconstruction at any time of the follow-up (p = n.s.).
Eight patients (19%) of the ACL repair group presented with recurrent instability and underwent single-stage revision reconstruction with hamstring autografts. Another four patients (9%) showed increased laxity with insufficient healing after ACL repair but did not require revision. In the ACL reconstruction group, five patients (13%) sustained a re-tear after return to their previous activity level. However, in In three cases a two-staged revision was required. Recurrent instability was associated with young age and higher Tegner scores in both groups.

Conclusion

Five years after ACL repair functional results were comparable to those after ACL reconstruction. However, the rate of recurrent ACL insufficiency was increased after ACL repair. In the revision situation, single-stage revision was possible in all cases following primary repair, whereas after primary reconstruction, a two-staged revision had to be performed in three of five cases.

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Meniscal Root Repair In Pediatric Patients: Minimum 2-Year Outcomes ePoster Presentation Cliff Willimon, MD, UNITED STATES Michael T. Busch, MD, UNITED STATES Asahi Murata, BS, UNITED STATES Crystal A. Perkins, MD, UNITED STATES
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Tibial Coverage After Total Knee Arthroplasty: Ct Comparison Between Symmetric And Asymmetric Baseplates ePoster Presentation Thomas Neri, MD, PhD, Prof., FRANCE Elise BOULGAKOFF, Ing, FRANCE Christophe RASCLE, ing, FRANCE Sven Edward Putnis, MB ChB FRCS(Tr&Orth), UNITED KINGDOM Antonio Klasan, MD, PhD, EMBA, FRCS, AUSTRIA Remi Philippot, MD, PhD, Prof, FRANCE
Assessment of Anatomical Femoral and Tibial ACL's Footprints Using Specific MRI Sequences: Compressed Lateral and Anteroposterior Anatomical Systematic Sequences "CLASS" ePoster Presentation Grégoire Thürig, MD, SWITZERLAND Raul Panadero-Morales, MSc in Industrial and Mechanical Engineering, SPAIN Luca Giovannelli, PhD, SPAIN Franziska Kocher, MD, SWITZERLAND José L Peris, PhD in Biological Sciences, SPAIN Moritz Tannast, Prof., SWITZERLAND Daniel Petek, MD, SWITZERLAND
Performing A Concomitant Tibial Tubercle Osteotomy During Primary Medial Patellofemoral Ligament Reconstruction Does Not Lead To Increased Post-Operative Complication Rates Abstract Presentation 5 minutes Adam Money, MD, UNITED STATES Seth L. Sherman, MD, UNITED STATES Kunal Varshneya, BS, UNITED STATES Andrew Gudeman, MD, UNITED STATES Kevin G. Shea, MD, UNITED STATES
Second Anterior Cruciate Ligament Injury Rates In Younger Athletes Advised To Delay Their Return To Sport ePoster Presentation Kate E. Webster, PhD, AUSTRALIA Julian A. Feller, FRACS, FAOrthA, AUSTRALIA Haydn Klemm, BFSc&Nutr (Hons), AUSTRALIA
ACL injury associated meniscus tears in pediatric and adolescent patients: incidence, management and outcome ePoster Presentation Luca Rigamonti, MD, ITALY Nathaniel Bates, PhD, UNITED STATES Nathan Schilaty, DC, PhD, UNITED STATES Michael J. Stuart, MD, UNITED STATES Marco Bigoni, ITALY Todd A Milbrandt, MD Aaron J. Krych, MD, UNITED STATES

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Five Year Results of a Prospective Randomized Controlled Trail: ACL Repair vs. ACL Reconstruction.

Five Year Results of a Prospective Randomized Controlled Trail: ACL Repair vs. ACL Reconstruction.

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Five Year Results of a Prospective Randomized Controlled Trail: ACL Repair vs. ACL Reconstruction.

Five Year Results of a Prospective Randomized Controlled Trail: ACL Repair vs. ACL Reconstruction.

Background

Methods

Results

Conclusion