Dataset Information

Arthroscopic Primary Posterior Cruciate Ligament Repair With Suture Augmentation.

ABSTRACT: Isolated posterior cruciate ligament (PCL) injuries are relatively rare and PCL injuries most commonly occur in the setting of multiligamentous knee injuries. PCL injuries can be treated with primary repair, which has the advantages of preserving the native tissue, maintaining proprioception, and minimal invasive surgery when compared with reconstruction surgery. Historically, primary repair of PCL injuries was performed in all tear types using an open approach, and, although the subjective outcomes were relatively good, patients often had residual laxity. Modern advances and increasing knowledge could improve the outcomes of PCL repair. With magnetic resonance imaging patients with proximal tears and sufficient tissue quality can be selected, and with arthroscopy and suture anchors minimal invasive surgery with direct fixation can be performed. Furthermore, with suture augmentation the healing of the repaired PCL can be protected and the residual laxity can be prevented. In this Technical Note, we describe the surgical technique of arthroscopic primary repair of proximal PCL tears with suture anchors and suture augmentation. The goal of arthroscopic primary repair is the preservation of the native PCL using a minimally invasive method and subsequent protection of this repair using suture augmentation.

SUBMITTER: van der List JP

PROVIDER: S-EPMC5794909 | biostudies-other | 2017 Oct

REPOSITORIES: biostudies-other

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Arthroscopic Primary Posterior Cruciate Ligament Repair With Suture Augmentation.

van der List Jelle P JP DiFelice Gregory S GS

Arthroscopy techniques 20170925 5

Isolated posterior cruciate ligament (PCL) injuries are relatively rare and PCL injuries most commonly occur in the setting of multiligamentous knee injuries. PCL injuries can be treated with primary repair, which has the advantages of preserving the native tissue, maintaining proprioception, and minimal invasive surgery when compared with reconstruction surgery. Historically, primary repair of PCL injuries was performed in all tear types using an open approach, and, although the subjective outc ...[more]

PMID: 29399451

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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

Arthroscopic Primary Posterior Cruciate Ligament Repair With Suture Augmentation.

Publications

Arthroscopic Primary Posterior Cruciate Ligament Repair With Suture Augmentation.

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