Anterior cruciate ligament repair with internal brace augmentation: A systematic review

Wilson, William T.; Hopper, Graeme P.; Banger, Matthew; Blyth, Mark; Riches, Philip; Mackay, Gordon

doi:10.1016/j.knee.2022.03.009

Cited by 52 publications

(48 citation statements)

References 69 publications

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“…While arthroscopic ACL reconstruction (ACL-R) using autologous grafts is still considered the gold-standard surgical treatment,4 the rapid evolution of arthroscopic techniques and devices in recent years has resurrected the interest in primary repair of proximal ACL ruptures, where the ligament is preserved by suturing with or without reinforcement 5 6. For instance, Mackay et al introduced a synthetic brace meant as secondary stabiliser of the primary ACL repair, thus stimulating and ensuring the healing of the ligament 7.…”

Section: Introductionmentioning

confidence: 99%

RetroBRACE: clinical, socioeconomic and functional–biomechanical outcomes 2 years after ACL repair and InternalBrace augmentation in comparison to ACL reconstruction and healthy controls—experimental protocol of a non-randomised single-centre comparative study

et al. 2022

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IntroductionDespite good clinical outcomes reported in the literature, to date, scientific evidence for the functional and biomechanical benefit of primary anterior cruciate ligament (ACL) repair with augmentation is scarce. We present an experimental protocol for a detailed multimodal (clinical, socioeconomic, functional and biomechanical) comparative study in patients after primary ACL repair and InternalBrace augmentation, patients after ACL reconstruction and healthy controls.Methods and analysisIn this non-randomised single-centre comparative study with prospective data collection with three arms (patients 2 years after ACL repair and InternalBrace augmentation; patients 2 years after ACL reconstruction using hamstring autografts; and healthy controls), 30 participants per study arm will be included. The study is designed as non-inferiority study with three arms. Required sample size was estimated based on data reported in the literature on muscle strength, proprioception and balance parameters, resulting in at least 28 participants per group. Outcome parameters include patient-reported outcome measures (EQ-5D-5L, Tegner Activity Scale, Knee Injury and Osteoarthritis Outcome Score (KOOS), International Knee Documentation Committee and ACL-Return to Sports Injury Scale), socio-economic parameters, anterior tibial translation, range of motion and functional-biomechanical data of the lower extremities. Functional–biomechanical parameters include proprioception, isokinetic muscle strength, single-leg balance, walking, running and single-leg hops with additional lower extremity 3D joint kinematics and kinetics and muscle activity. These parameters will be compared between limbs in patients, between groups and to the current literature.Ethics and disseminationThe results of this study will be disseminated through peer-reviewed publications and presentations at national and international conferences. Ethical approval was obtained by the regional ethics board (Ethics Committee Northwest Switzerland EKNZ 2020–00551), and the study is registered at clinicaltrials.gov.Trial registration numberNCT04429165.

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Section: Introductionmentioning

confidence: 99%

RetroBRACE: clinical, socioeconomic and functional–biomechanical outcomes 2 years after ACL repair and InternalBrace augmentation in comparison to ACL reconstruction and healthy controls—experimental protocol of a non-randomised single-centre comparative study

et al. 2022

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“…The ROM of the knee was measured bilaterally using a standard goniometer. 23 Anterior knee stability was evaluated manually using the Lachman test and anterior drawer test, according to the ligament examination section of the IKDC 2000 Knee Examination Form. The inter-limb difference in anterior tibial dislocation obtained from the Lachman test and anterior drawer test was rated as normal (0; 0-2 mm), nearly normal (1+; 3-5 mm), abnormal (2+; 6-10 mm), or severely abnormal (3+; >10 mm).…”

Section: Methodsmentioning

confidence: 99%

“…The inter-limb difference in anterior tibial dislocation obtained from the Lachman test and anterior drawer test was rated as normal (0; 0-2 mm), nearly normal (1+; 3-5 mm), abnormal (2+; 6-10 mm), or severely abnormal (3+; >10 mm). 23 Anterolateral rotational knee stability was assessed manually with the pivot-shift test. The pivot-shift was considered negative when, according to the ligament examination section of the 2000 IKDC Knee Examination Form, the anterolateral rotational dislocation of the tibia relative to the femur was equal in both lower limbs and positive when the difference between the limbs was rated as + (glide),++ (clunk) or +++ (gross).…”

Section: Methodsmentioning

confidence: 99%

Clinical assessment and comparison of ACL reconstruction using synthetic graft (Neoligaments versus FiberTape)

Barnaś¹,

Kentel²,

Morasiewicz³

et al. 2021

Adv Clin Exp Med

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Background. Due to the low potential for primary biological healing of the anterior cruciate ligament (ACL), the most popular approach is currently reconstruction using a graft. Recent research indicates that the technique of strengthening a damaged ligament with synthetic tapes (internal bracing) may be an alternative to reconstructive treatment, especially in cases of partial ACL damage.Objectives. To compare and evaluate the possibility of using a synthetic graft (Neoligaments or FiberTape) to treat partial lesions of the ACL. Materials and methods.This was a retrospective cohort study. Selected from a pool of 128 patients undergoing primary unilateral intra-articular ACL reconstruction due to partial lesion of the ACL, group I (Neoligaments) and group II (FiberTape) each included 30 patients. Range of motion (ROM), the Lachman test, the anterior drawer test and the pivot-shift test, the Lysholm Knee Scoring Scale, and International Knee Documentation Committee (IKDC) 2000 scale were used for assessment. Follow-up was carried out after 2 years.Results. The knee joint regained anterior stability in both the subjective and objective assessments in all patients in both groups. The subjective results were respectively: in group I, 97.2 ±3.2 points on the Lysholm scale and 93.9 ±6. 1 points on the IKDC 2000 scale; in group II, 96. 1 ±4.9 points on the Lysholm scale and 93.2 ±6.8 points on the IKDC 2000 scale. Group comparison of the results of the IKDC 2000 scale, Lysholm Scale and ROM obtained postoperatively showed no statistically significant differences between groups.Conclusions. Reconstruction of partial ACL lesions using a synthetic graft allows regained stability of the knee joint. The results of subjective assessment are comparable with the functional assessment results. The comparison between Neoligaments and FiberTape shows the same functional and objective results, although FiberTape is preferable from an economical perspective.

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“…Mackay and colleagues have been performing IBLA for nearly the past decade and have reported long-term follow-up data on dozens of patients. 38,52,91 The stability and strength provided by internal bracing is not limited to primary repair and variations in the technique have been described as well. 50,79,84,87 Internal bracing is reserved for Sherman type I proximal ruptures with good tissue quality.…”

Section: Surgical Techniquesmentioning

confidence: 99%

“…These techniques are in the literature under internal brace ligament augmentation (IBLA), suture ligament augmentation, or suture tape augmentation. 19,32,80,91 All rely on similar construct and methodology of using polyethylene tape as an internal brace within the repaired ACL (Figure 3). Biomechanical models have shown its stabilization potential at loads occurring during normal daily activity.…”

Section: Internal Bracementioning

confidence: 99%

Rehabilitation Principles to Consider for Anterior Cruciate Ligament Repair

Kator

Zarro

et al. 2021

Sports Health

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Context: Injury to the anterior cruciate ligament (ACL) is among the most common orthopaedic injuries, and reconstruction of a ruptured ACL is a common orthopaedic procedure. In general, surgical intervention is necessary to restore stability to the injured knee, and to prevent meniscal damage. Along with surgery, intense postoperative physical therapy is needed to restore function to the injured extremity. ACL reconstruction (ACLR) has been the standard of care in recent decades, and advances in surgical technology have reintroduced the prospect of augmented primary repair of the native ACL via a variety of methods. Evidence Acquisition: A search of PubMed database of articles and reviews available in English was performed through 2020. The search terms ACLR, anterior cruciate ligament repair, bridge enhanced acl repair, suture anchor repair, dynamic intraligamentary stabilization, internal bracing, suture ligament augmentation, and internal brace ligament augmentation were used. Study Design: Clinical review. Level of Evidence: Level 5. Results: No exact consensus exists on effective rehabilitation protocols after ACL repair techniques, as the variation in published protocols seem even greater than the variation in those for ACLR. For some techniques such as internal bracing and dynamic interligamentary stabilization, it is likely permissible for the patients to progress to full weightbearing and discontinue bracing sooner. However, caution should be applied with regard to earlier return to sport than after ACLR as to minimize risk for retear. Conclusion: More research is needed to address how physical therapies must adapt to these innovative repair techniques. Until that is accomplished, we recommend that physical therapists understand the differences among the various ACL surgery techniques discussed here and work with the surgeons to develop a rehabilitation protocol for their mutual patients. Strength of Recommendation Taxonomy (SORT): C.

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Anterior cruciate ligament repair with internal brace augmentation: A systematic review

Cited by 52 publications

References 69 publications

RetroBRACE: clinical, socioeconomic and functional–biomechanical outcomes 2 years after ACL repair and InternalBrace augmentation in comparison to ACL reconstruction and healthy controls—experimental protocol of a non-randomised single-centre comparative study

RetroBRACE: clinical, socioeconomic and functional–biomechanical outcomes 2 years after ACL repair and InternalBrace augmentation in comparison to ACL reconstruction and healthy controls—experimental protocol of a non-randomised single-centre comparative study

Clinical assessment and comparison of ACL reconstruction using synthetic graft (Neoligaments versus FiberTape)

Rehabilitation Principles to Consider for Anterior Cruciate Ligament Repair

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