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Anterior Cruciate Ligament Repair Using Dynamic Intraligamentary Stabilization Provides a Similarly Successful Outcome As All-Inside Anterior Cruciate Ligament Reconstruction With A Faster Psychological Recovery In Moderately Active Patients

Anterior Cruciate Ligament Repair Using Dynamic Intraligamentary Stabilization Provides a Similarly Successful Outcome As All-Inside Anterior Cruciate Ligament Reconstruction With A Faster Psychological Recovery In Moderately Active Patients

M. Enes Kayaalp, MD, Assoc. Prof., TURKEY Serkan Surucu, MD, UNITED STATES Mehmet Halis Çerçi, MD, TURKEY Mahmud Aydın, MD, TURKEY Mahir Mahirogullari, MD, Prof., TURKEY

Istanbul Sisli Memorial Hospital, Istanbul, TURKEY


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Treatment / Technique

Anatomic Location

Anatomic Structure

Diagnosis / Condition

Ligaments

ACL


Summary: Primary ACL repair using the dynamic intraligamentary stabilization (DIS) technique provides a similar clinical outcome to these by an all-inside ACL-R technique in moderately active patients. The DIS technique is reliable and reproducible, and associated with an early and speedier psychological recovery in a carefully selected, non-athlete patient group as observed by an independent group.


Objectives: This study aims to comparatively evaluate early to midterm clinical results of case-matched patient groups of primary repairs with dynamic intraligamentary stabilization (DIS) or all-inside anterior cruciate ligament (ACL) reconstruction (ACLR) by an independent group.
Patients and methods: Between March 2015 and September 2018, a total of 16 patients operated on for ACL injuries with the repair technique were retrospectively identified. Cases were stratified by treatment: DIS technique versus all-inside ACLR and matched at a ratio of 1:2. The ACLR patients were selected from a patient group with an injury-to-operation time interval of fewer than three months. A total of 32 patients were included in the all-inside ACLR group. Pre-injury and postoperative International Knee Documentation Committee (IKDC) subjective scores, Tegner and Lysholm scores were obtained. Additionally, ACL Return to Sport after Injury (ACL-RSI) scale scores, clinical results, and complications were noted.
Results: One (6%) patient in the DIS group and two (6%) patients in the ACLR group were lost-to-follow-up and, for a total of 45 patients, 15 in the DIS group and 30 in the ACLR group, were included in the study. The mean postoperative follow-up was 50.8±13.5 months and 48.2±11.4 months in the DIS and ACLR groups, respectively. The Tegner, Lysholm, and IKDC subjective scores were non-significantly different between the groups at any time points. The ACL-RSI scale scores were significantly higher at six (p<0.001) and 12 (p=0.01) months in the repair group. The pivot-shift test was negative in all cases postoperatively. One re-rupture occurred in each group. The reoperation rate at any cause was 25% for the repair and 10% for the ACLR group.
Conclusion: Primary ACL repair using the DIS technique provides a similar clinical outcome to these by an all-inside ACLR technique in moderately active patients. The DIS technique is reliable and reproducible and associated with an early and speedier psychological recovery in a carefully selected, non-athlete patient group as observed by an independent group.


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