Summary
Retrospective Case Series on Primary ACL Repair with Adjustable Loop Femoral Fixation and Tape Augmentation
Abstract
Background
Historically, primary repair for anterior cruciate ligament (ACL) ruptures has resulted in a relatively high retear rate compared to standard ACL reconstruction. A new approach utilizing adjustable loop femoral fixation to allow for repair retensioning has been developed but outcomes have not yet been reported.
Purpose
To describe patient outcomes following primary ACL repair for proximal Sherman types 1 and 2 ACL tears done with an adjustable loop device for femoral fixation with suture tape augmentation.
Level of Evidence: Retrospective Case Series, IV.
Methods
This is a single center, retrospective cohort study describing short- to mid-term follow-up of patients who underwent primary ACL repair done with an adjustable loop device for femoral fixation. Patients were included if they presented with a proximal Sherman type 1 or 2 ACL tears and opted to undergo primary ACL repair and had a minimum of 1-year follow-up. Patients were excluded if they demonstrated midsubstance ACL tears. Physical examination findings including KT-1000 arthrometer measurements were collected both pre- and postoperatively. Patient-reported outcomes (PROs) were collected at final follow-up. Complications such as ACL retear, postoperative knee stiffness, and subsequent non-ACL knee surgery was also reported.
Results
There was a total of 41 patients (22 males, 19 females) with a mean patient age of 27.8 years and final follow-up of 2.9 years were included in final data analysis. There were 11 patients (26.8%) who under concomitant meniscal procedures, 4 patients (9.76%) underwent concomitant medial collateral ligament repair with suture tape augmentation, 4 patients (9.76%) underwent a concomitant lateral ligament procedure (3 lateral collateral ligament repair with suture tape augmentation and 1 posterolateral corner reconstructions), and 13 patients (31.7%) underwent anterolateral ligament (ALL) reconstruction with allograft.
Conclusion
Primary ACL repair with knotless adjustable loop fixation and suture tape augmentation for proximal Sherman types 1 and 2 ACL tears resulted in satisfactory subjective and objective PROs. Additional multicenter studies are needed to truly understand the utilization of primary ACL repair especially when compared to ACL reconstruction.