Summary
This study found no impact of using synthetic tape augmentation for ACL reconstruction on knee stability, revision rate or subjective outcome
Abstract
Background
Internal bracing with suture tape is a synthetic ligament augmentation that potentially acts as a “seat belt” during the early healing and rehabilitation phase after an anterior cruciate ligament reconstruction (ACLR). Biomechanical testing has showed that suture tape augmentation improves the strength of the graft construct which may lead to improved clinical outcomes.
Aim
The aim of this present study was to compare clinical outcomes in ACLR patients with and without suture tape augmentation with data from the Danish Knee Reconstruction Registry (DKRR).
Materials And Methods
A cohort of patients undergoing ACLR with either hamstring tendon autografts or quadriceps tendon autografts in combination with a synthetic ligament augmentation (InternalBrace) was identified in DKRR. By using a propensity score, the InternalBrace group was matched 1:1 to a group of ACLR patients without tape augmentation (control group). The primary outcome was sagittal knee laxity and secondary outcomes were revision surgery rates, rotational stability with the pivot shift test and patient reported outcome measures (PROMs) with the Knee Injury and Osteoarthritis Outcome Score (KOOS).
Results
A total of 358 patients were included, 179 in the InternalBrace group and 179 in the control group. At one-year follow-up the InternalBrace group demonstrated a higher sagittal knee laxity of 2.1 mm compared to 1.3 mm in the control group (p= <0.01). There was no difference in the odds of having a positive pivot shift in the InternalBrace group (17% positive) compared to the control group (16%) (p= 0.585). There was no difference in any of the KOOS subcategories between the groups (p>0.05 for all comparisons). At two-years follow-up 2 patients had a revision surgery in the InternalBrace group compared to 3 patients in the control group.
Conclusion
Patients undergoing ACLR with suture tape augmentation had an increased sagittal knee laxity compared to standard ACLR one-year postoperatively. There was no difference in pivot shift, PROMs and revision rates.