Dataset Information

Primary Repair of Tibial-Sided Avulsion of the Anterior Cruciate Ligament.

ABSTRACT: Lesions of the anterior cruciate ligament (ACL) are common; the current gold standard of treatment for such lesions is ACL reconstruction. Tibial-sided soft-tissue avulsion is a rare subtype of ACL injuries. Unlike femoral-sided ACL repair, surgery for acute tibial-sided ACL ruptures has been neither reported nor described. This technical note presents a method for primary anatomic ACL reinsertion for an acute distal soft-tissue avulsion-type ACL injury, using a transosseous pull-out repair technique. Our technique, as an alternative to reconstruction, has the potential to enhance healing due to marrow stimulation (tibial tunneling). It also preserves the native insertion site and proprioceptive function, which may, in turn, reduce the risk of post-traumatic osteoarthritis.

SUBMITTER: Sheth MR

PROVIDER: S-EPMC5040597 | biostudies-literature | 2016 Aug

REPOSITORIES: biostudies-literature

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Primary Repair of Tibial-Sided Avulsion of the Anterior Cruciate Ligament.

Sheth Miten Rajendra MR Tapasvi Sachin Ramchandra SR Patil Shantanu Sudhakar SS

Arthroscopy techniques 20160815 4

Lesions of the anterior cruciate ligament (ACL) are common; the current gold standard of treatment for such lesions is ACL reconstruction. Tibial-sided soft-tissue avulsion is a rare subtype of ACL injuries. Unlike femoral-sided ACL repair, surgery for acute tibial-sided ACL ruptures has been neither reported nor described. This technical note presents a method for primary anatomic ACL reinsertion for an acute distal soft-tissue avulsion-type ACL injury, using a transosseous pull-out repair tech ...[more]

PMID: 27709056

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Project description:PurposeTo assess failure rate, outcomes, and patient satisfaction in patients who underwent anterior cruciate ligament (ACL) repair with suture augmentation for clinical instability and proximal avulsion of the ACL.MethodsWe retrospectively reviewed consecutive suture-augmented ACL repairs performed by a single surgeon between January 2014 and June 2016 for proximal ACL avulsion. Patients were included if they were at least 24 months postoperative from repair surgery. Patients were excluded from the study if they underwent primary ACL reconstruction instead of repair or if they had a concomitant multiligamentous knee injury. Knee Injury and Osteoarthritis Outcome Score (KOOS), visual analog scale (VAS), Veterans RAND-12 (VR-12), Marx Activity, and Single Assessment Numeric Evaluation data were collected.ResultsOf 172 patients who underwent ACL surgery between January 2014 and June 2016, 28 (16%) with Sherman type I or II ACL tears or high-grade partial avulsion with clinical instability underwent ACL repair with suture augmentation. One patient was not available for follow-up. The 27 patients were age 27.4 ± 8.6 years, 18 males (66.7%), and 2.8 ± 0.7 years follow-up (range, 2.0-3.8 years). Of these 27 patients, 4 recurrent ACL injuries (14.8%) required revision to reconstruction. The remaining 23 patients had successful ACL repair with no clinical instability and no subjective complaints at final follow-up. Final scores were KOOS 83.7 ± 12.8, Marx 8.6 ± 4.0, VAS 1.1 ± 1.8, physical VR-12 53.6 ± 5.2, mental VR-12 53.1 ± 8.1, and Single Assessment Numeric Evaluation 83.0 ± 12.9. In the 11 patients with baseline data, significant improvements were observed in composite KOOS (50.4 ± 11.5 to 85.7 ± 8.4; P < .001; VAS: 3.9 ± 2.6 to 0.8 ± 0.8; P = .002; and physical VR-12: 39.9 ± 6.5 to 55.5 ± 3.3; P < .001). All 11 patients (100%) met or exceeded the KOOS composite minimum clinically important difference (mean 34.0 increase).ConclusionsIn patients with proximal ACL avulsion, arthroscopic primary ACL repair with suture augmentation demonstrated high functional outcome and improved patient-reported outcomes at 2-year follow-up. The rate of graft failure was 15%.Level of evidenceLevel IV, therapeutic case series.

Dataset Information

Primary Repair of Tibial-Sided Avulsion of the Anterior Cruciate Ligament.

Publications

Primary Repair of Tibial-Sided Avulsion of the Anterior Cruciate Ligament.

Similar Datasets

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