Arthroscopic anterior cruciate ligament repair for proximal anterior cruciate ligament tears in skeletally immature patients: Surgical technique and preliminary results

Bigoni, Marco; Gaddi, Diego; Gorla, Massimo; Munegato, Daniele; Pungitore, Marco; Piatti, Massimiliano; Turati, Marco

doi:10.1016/j.knee.2016.09.017

Cited by 54 publications

(61 citation statements)

References 62 publications

(78 reference statements)

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“…reported outcomes at medium-to long-term follow-up (range of mean follow-up 43.3-79 months) 41,48,49,52 including the mean IKDC subjective score (range 87.3-100), the mean Lysholm score (range 85.3-100), and the mean Tegner activity score (range 5-7). The remaining 10 studies 36,40,[42][43][44][45][46]50,51,53 reported the same outcome measures at short-term follow-up (range of mean follow up 12-38.4 months). At final follow-up, these studies reported a mean IKDC subjective score of 89.5-98, a mean Lysholm score of 93-100, and a mean Tegner activity score of 5-7.…”

Section: Clinical Outcomes Reported In Comparative Studiesmentioning

confidence: 93%

“…The remaining 14 studies were Level IV cases series. [40][41][42][43][44][45][46][47][48][49][50][51][52][53] The flowchart for the search strategy is depicted in Figure 1.…”

Section: Study Selectionmentioning

confidence: 99%

“…A total of 1002 patients who underwent arthroscopic primary ACL repair formed the overall population evaluated in this systematic review. These patients underwent ACL repair with either suture anchor repair (SAR) (n ¼ 158), 37,39,42,46,48,49 dynamic intraligamentary stabilization with Ligamys (DIS Ligamys) (n ¼ 779), 35,36,40,41,43,44,[50][51][52][53] bridge-enhanced ACL repair technique (i.e., BEAR) (n ¼ 10), 38 suture pullout repair (n ¼ 13), 45 or augmented ACL repair using suture tape reinforcement with internal brace (IB) (Internal Brace Ligament Augmentation Repair; Arthrex, Naples, FL) 47 (n ¼ 42).…”

Section: Arthroscopic Primary Acl Repair Techniquesmentioning

confidence: 99%

“…However, other authors also reported high rates of reoperation for removal including Kohl et al, 40 who reported a rate of 60%. Six 36,40,44,50,51,53 of the eight 36,40,42,44,[50][51][52][53] noncomparative studies evaluating DIS Ligamys reported clinically significant stiffness in 5.31% to 40% of their respective cohorts. The reoperation rate after DIS Ligamys for ACL reconstruction varied between 2.9% at 12 months 51 to 20% at 60 months.…”

Section: Clinical Outcomes Of Noncomparative Studiesmentioning

confidence: 99%

“…Seventeen of the included studies [35][36][37][38][39][40][41][42][43][44][45][46][47][48][49]52,53 reported the postoperative rehabilitation and return to sport protocols and these are summarized in Table 6. All of the comparative studies used the same rehabilitation protocol in both ACL repair and reconstruction groups.…”

Section: Postoperative Rehabilitation Protocolmentioning

confidence: 99%

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Clinical Outcomes of Arthroscopic Primary Anterior Cruciate Ligament Repair: A Systematic Review from the Scientific Anterior Cruciate Ligament Network International Study Group

Kandhari

Vieira

Ouanezar

et al. 2020

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Purpose: To perform a systematic review of contemporary studies reporting clinical outcomes of primary anterior cruciate ligament (ACL) repair to determine whether these studies demonstrate any significant benefit of ACL repair and whether there is evidence of a deterioration of mid-term outcomes as seen in historical data. Methods: A systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. A PubMed search using the keywords "repair" AND "Anterior Cruciate Ligament" was performed (limits: English language, publication date between January 1, 2014, and January 13, 2019). All identified studies reporting clinical outcomes of arthroscopic ACL repair were included. Critical appraisal was conducted using the Cochrane Risk of Bias Tool for Randomized Clinical Trials and the Methodological Index for Non-Randomized Studies. Basic parameters of each study including population characteristics, repair technique, physical examination findings, and clinical outcome scores were recorded and evaluated. Results: Nineteen eligible studies were identified (including 5 comparative studies). None of the comparative studies showed any significant difference between repair and reconstruction groups with respect to International Knee Documentation Committee (IKDC), Lysholm, Tegner, side-to-side laxity difference, Lachman, pivot shift tests, or graft rupture rates. Four non-comparative studies reported outcomes at medium-to long-term follow up (range of mean follow up 43.3-79 months) with a mean Lysholm score between 85.3 and 100, mean IKDC subjective score between 87.3 and 100, and mean Tegner activity score between 5 and 7. Conclusions: Comparative studies identified no significant differences between ACL repair and reconstruction with respect to Lysholm, IKDC, side-to-side laxity difference, pivot shift grade, or graft rupture rates. However, these studies had major limitations including small numbers and short durations of follow up. Case series demonstrated that excellent outcomes can be achieved at medium-to long-term follow up with the SAR technique. Level of Evidence: IV; Systematic review of Level II to IV investigations. See related article on page 613 H istorical results of open primary repair of the anterior cruciate ligament (ACL) have been characterized in the literature by good initial clinical outcomes, 1-6 with a significant deterioration at midterm follow-up and high rates of additional surgery (64%), including reoperation for ACL reconstruction (13%

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Section: Clinical Outcomes Reported In Comparative Studiesmentioning

confidence: 93%

“…The remaining 14 studies were Level IV cases series. [40][41][42][43][44][45][46][47][48][49][50][51][52][53] The flowchart for the search strategy is depicted in Figure 1.…”

Section: Study Selectionmentioning

confidence: 99%

Section: Arthroscopic Primary Acl Repair Techniquesmentioning

confidence: 99%

Section: Clinical Outcomes Of Noncomparative Studiesmentioning

confidence: 99%

Section: Postoperative Rehabilitation Protocolmentioning

confidence: 99%

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Clinical Outcomes of Arthroscopic Primary Anterior Cruciate Ligament Repair: A Systematic Review from the Scientific Anterior Cruciate Ligament Network International Study Group

Kandhari

Vieira

Ouanezar

et al. 2020

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Anterior cruciate ligament reconstruction in skeletally immature patients is effective: A systematic review

Migliorini,

Cocconi,

Schäfer

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeThe present study evaluated the outcomes of anterior cruciate ligament (ACL) reconstruction in children with open physes. The outcomes of interest were to compare the increase in joint laxity and PROMs from baseline to the last follow‐up, the rate and features of the return to sport and the rate of complications.MethodsThis study was conducted according to the 2020 PRISMA guidelines. In October 2023, the following databases were accessed: PubMed, Web of Science, Google Scholar and Embase. All the clinical studies investigating ACL reconstruction in skeletally immature patients were accessed. Only articles which clearly stated that surgeries were conducted in children with open physis were eligible.ResultsData from 53 studies (1691 procedures) were collected. 35% (597 out of 1691 patients) were women. The mean length of the follow‐up was 44.7 ± 31.3 months. The mean age of the patients was 12.7 ± 1.1 years old. All PROMs significantly improved from the baseline values to those at the last follow‐up. The mean time to return to sport was 8.3 ± 1.9 months. 89% (690 out of 771 patients) returned to sports, 15% (109 out of 721 patients) reduced their level of sports activity or league, and 84% (651 out of 771 patients) returned to their previous level of sport. 9% (112 out of 1213) of patients experienced re‐tear of the reconstructed ACL, and 11% (75 out of 660) of patients underwent a further ACL reoperation. No patients (0 out of 83) demonstrated increased laxity at the last follow‐up, and persistent sensation of instability was reported by 5% (11 out of 235) of patients.ConclusionACL reconstruction in skeletally immature patients is effective and safe, and is associated with fast recovery and a high rate of return to sport.Level of EvidenceLevel IV.

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Preservation of the Anterior Cruciate Ligament: Arthroscopic Primary Repair of Proximal Tears

List

Jonkergouw

DiFelice

2020

Lower Extremity Joint Preservation

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Arthroscopic anterior cruciate ligament repair for proximal anterior cruciate ligament tears in skeletally immature patients: Surgical technique and preliminary results

Cited by 54 publications

References 62 publications

Clinical Outcomes of Arthroscopic Primary Anterior Cruciate Ligament Repair: A Systematic Review from the Scientific Anterior Cruciate Ligament Network International Study Group

Clinical Outcomes of Arthroscopic Primary Anterior Cruciate Ligament Repair: A Systematic Review from the Scientific Anterior Cruciate Ligament Network International Study Group

Anterior cruciate ligament reconstruction in skeletally immature patients is effective: A systematic review

Preservation of the Anterior Cruciate Ligament: Arthroscopic Primary Repair of Proximal Tears

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