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

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

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.

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Abbreviations

ACL:

Anterior cruciate ligament

DIS:

Dynamic intraligamentary stabilization

DTI:

Diffusion tensor imaging

IKDC:

International Knee Documentation Committee

MRI:

Magnetic resonance imaging

PCL:

Posterior cruciate ligament

PROM:

Patient-reported outcome measure

RTS:

Return to sport

RTW:

Return to work

STA:

Suture tape augmentation technique

VAS:

Visual analogue scale

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Funding

No funding was available for this study.

Author information

Authors and Affiliations

  1. Antwerp University Hospital, Orthopaedics, Drie Eikenstraat 655, 2650, Edegem, Belgium

    Christiaan H. W. Heusdens, Karen Blockhuys, Ella Roelant, Lieven Dossche, Francis Van Glabbeek & Pieter Van Dyck

  2. University of Antwerp, Antwerp, Belgium

    Ella Roelant, Francis Van Glabbeek & Pieter Van Dyck

Authors
  1. Christiaan H. W. Heusdens
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  2. Karen Blockhuys
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  3. Ella Roelant
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  4. Lieven Dossche
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  5. Francis Van Glabbeek
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  6. Pieter Van Dyck
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Contributions

This manuscript has been written by Dr. Heusdens who treated study patients, collected study data, and who was a major contributor to the writing of the manuscript, Karen Blockhuys who was a major contributor to the writing of the manuscript, Ella Roelant who performed statistical analyses on the study data and helped editing the manuscript, Dr. Dossche who treated study patients, collected study data, and helped editing the manuscript, Prof. Van Glabbeek who helped editing the manuscript, and Prof. Van Dyck who interpreted MRI scans of study participants and helped editing the manuscript.

Corresponding author

Correspondence to Christiaan H. W. Heusdens.

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Conflict of interest

Christiaan Heusdens: none; Karen Blockhuys: none; Ella Roelant: none; Lieven Dossche: none; Francis Van Glabbeek: none; Pieter Van Dyck: none.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee of the Antwerp University Hospital (B300201525523, 15/32/330) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Heusdens, C.H.W., Blockhuys, K., Roelant, E. et al. Suture tape augmentation ACL repair, stable knee, and favorable PROMs, but a re-rupture rate of 11% within 2 years. Knee Surg Sports Traumatol Arthrosc 29, 3706–3714 (2021). https://doi.org/10.1007/s00167-020-06399-2

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