Anterior Cruciate Ligament Repair Outcomes: An Updated Systematic Review of Recent Literature

Nwachukwu, Benedict U.; Patel, Bhavik H.; Lu, Yining; Allen, Answorth A.; Williams, Riley J.

doi:10.1016/j.arthro.2019.04.005

Cited by 69 publications

(72 citation statements)

References 47 publications

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“…4,5 With strict indications, our experience with this technique so far has been positive for severe cases. 4 We therefore agree with Nwachukwu et al 1 that the renewed interest and improvement in primary ACL repairs compared with the 1970s and 1980s are a result of improved surgical techniques (arthroscopic vs open surgery). However, we believe that the results of the present systematic review regarding the outcomes of ACL repair require additional interpretation.…”

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confidence: 80%

“…In their work, Nwachukwu et al 1 have shown that in recent years, there has been an increasing interest in procedures for ACL repair. This is recognizable by the large number of studies published on this topic in recent years, most of which have come from Europe.…”

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confidence: 99%

“…Nevertheless, comparison with data from the literature on cruciate ligament reconstruction shows that cruciate ligament reconstruction is superior to ACL repair in terms of reruptures and reoperations, as well as regarding improvement in patient-reported outcome measures (PROMs). 1 For this reason, cruciate ligament reconstruction continues to be the gold standard for the surgical treatment of cruciate ligament rupture in most patients. 1 We fully agree with the last statement.…”

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confidence: 99%

“…1 For this reason, cruciate ligament reconstruction continues to be the gold standard for the surgical treatment of cruciate ligament rupture in most patients. 1 We fully agree with the last statement. ACL reconstruction with an autologous tendon graft is still the gold standard for protecting the knee joint from secondary meniscal injury and for improving knee function in patients with anterior instability.…”

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confidence: 99%

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Editorial Commentary: Back to the Past—Anterior Cruciate Ligament Repair Revisited

Petersen¹,

Achtnich

2019

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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There has been increasing scientific interest in primary anterior cruciate ligament (ACL) repair in recent years. The results of these procedures have improved significantly compared with the 1970s and 1980s. Nevertheless, the overall rerupture rates after ACL repair are worse than after ACL reconstruction, and patient-reported outcome measures do not improve after ACL repair, in contrast to those after ACL reconstruction. However, because primary ACL repair is performed in the acute phase, improvement in patient-reported outcome measures after surgery is not expected. We believe that in the future, primary ACL repair will be established next to ACL reconstruction and nonsurgical therapy. One possible indication is a proximal ACL rupture. Which surgical technique will prevaildand whether orthobiological treatments such as platelet-rich plasma or stem cells will improve postoperative outcomes after ACL repairdwill need further clarification by clinical trials.

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confidence: 80%

Section: See Related Article On Page 2233mentioning

confidence: 99%

Section: See Related Article On Page 2233mentioning

confidence: 99%

Section: See Related Article On Page 2233mentioning

confidence: 99%

See 2 more Smart Citations

Editorial Commentary: Back to the Past—Anterior Cruciate Ligament Repair Revisited

Petersen¹,

Achtnich

2019

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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“…Demostró resultados funcionales comparables a la reconstrucción (Lysholm e IKDC), retorno deportivo precoz comparado con reconstrucción (14 semanas), satisfacción de los pacientes 90%, pero con tasas muy altas aún de re-rotura y revisión (23 y 12% respectivamente). 9 Esto probablemente en contexto que abarca estudios desde años iniciales donde no se consideraba aun las características que debía tener el paciente para ser el candidato ideal a optar por esta cirugía.…”

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Reparación Ligamento Cruzado Anterior, ¿Mito o Realidad?

Garrido

2019

Rev Chil Ortop Traumatol

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Diffusion tensor imaging of the anterior cruciate ligament following primary repair with internal bracing: A longitudinal study

Dyck

Froeling

Heusdens

et al. 2020

Journal Orthopaedic Research

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Diffusion tensor imaging (DTI) provides information about tissue microstructure and its degree of organization by quantifying water diffusion. We aimed to monitor longitudinal changes in DTI parameters (fractional isotropy, FA; mean diffusivity, MD; axial diffusivity, AD; radial diffusivity, RD) of the anterior cruciate ligament (ACL) following primary repair with internal bracing (IBLA). Fourteen patients undergoing IBLA were enrolled prospectively and scheduled for clinical follow‐up, including instrumented laxity testing, and DTI at 3, 6, 12, and 24 months postoperatively. DTI was also performed in seven healthy subjects. Fiber tractography was used for 3D segmentation of the whole ACL volume, from which median DTI parameters were calculated. The posterior cruciate ligament (PCL) served as a control. Longitudinal DTI changes were assessed using a linear mixed model, and repeated measures correlations were calculated between DTI parameters and clinical laxity tests. At follow‐up, thirteen patients had a stable knee and one patient sustained an ACL rerupture after 12 months postoperatively. The ACL repair showed a significant decrease of FA within the first 12 months after surgery, followed by stable FA values thereafter, while ACL diffusivities decreased over time returning towards normal values at 24 months postoperatively. For PCL there were no significant DTI changes over time. There was a significant correlation between ACL FA and laxity tests (r = −0.42, P = .017). This study has shown the potential of DTI to longitudinally monitor diffusion changes in the ACL following IBLA. The DTI findings suggest that healing of the ACL repair is incomplete at 24 months postoperatively.

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Anterior Cruciate Ligament Repair Outcomes: An Updated Systematic Review of Recent Literature

Cited by 69 publications

References 47 publications

Editorial Commentary: Back to the Past—Anterior Cruciate Ligament Repair Revisited

Editorial Commentary: Back to the Past—Anterior Cruciate Ligament Repair Revisited

Reparación Ligamento Cruzado Anterior, ¿Mito o Realidad?

Diffusion tensor imaging of the anterior cruciate ligament following primary repair with internal bracing: A longitudinal study

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