Summary
53 BTB ACLR + STA vs. 62 traditional BTB ACLR (mean age, < 19 years; mean follow-up, 5 years). Significantly less revision ACLR in STA group (0 vs. 5 [8.1%], p = 0.035). Comparable PROMs, RTS, and activity levels preoperatively and at final follow-up.
Abstract
Purpose
To investigate patient outcomes, including revision rate, following primary bone patellar-tendon
bone autograft (BTB) anterior cruciate ligament reconstruction (ACLR) with and without suture tape
augmentation (STA) in a young and active cohort.
Methods
All eligible patients who received primary BTB ACLR at this institution with a minimum of 2-
year follow-up were included in this study. Patients completed the following patient-reported outcome
measures (PROMs): the Visual Analog Scale (VAS) for pain, the Single Assessment Numeric Evaluation
(SANE), the Knee Injury and Osteoarthritis Outcome Score (KOOS) subscales, and the Tegner activity
scale. Anteroposterior knee laxity was assessed using a KT-1000 arthrometer preoperatively and 1-year
postoperatively. Subsequent surgical interventions and return to sport (RTS) was obtained from each
patient.
Results
One hundred and fifteen patients (53 BTB ACLR with STA, 62 traditional BTB ACLR) with a
mean patient age < 19-years-old and a mean final follow-up of = 5 years were included in final data
analysis. Compared to the control group, the STA group demonstrated significantly less subsequent
revision ACLR (0 vs. 5, p = 0.035). All PROMs and KT-1000 measurements improved at final follow-up (p
< 0.001) and were comparable between groups. Over 85% of the patients were able to return to the sport
that led to their injury at full capacity with no differences seen in RTS rate, time to RTS, or level of
competition between groups.
Conclusion
Compared to traditional BTB ACLR, additional STA may safely and effectively reduce the
rate of revision ACLR while maintaining acceptable PROMs and objective joint laxity measurements in a
young patient population with a high rate of returning to the same level of sport competition or higher.
Level of evidence: Retrospective cohort study, III.