Augmented repair and early mobilization of acute anterior cruciate ligament injuries

Abstract

This paper describes a technique for repair of the anterior cruciate ligament with protection of that repair by a synthetic augmentation device. Of 61 patients who underwent surgery 24 to 57 months (mean, 38.3) before data accumulation, 57 returned for followup. Subjectively, 53 (93%) patients reported a good or excellent functional result; however, only 29 (51%) of the patients returned to their preinjury sports level. Objectively, a radiographic Lachman test was performed on both the injured and the noninjured knee of all 57 patients. The preoperative mean difference between the knees was 8.6 mm (range, 4.6 to 17.2) and at followup it was 2.4 mm (range, -0.9 to 11.8). Radiographic abduction and adduction stress tests demonstrated stable healing of the (unrepaired) collateral ligament lesions (varus stress = 0.1 mm and valgus stress = 0.4 mm mean side-to-side difference), indicating that suturing of ruptured collateral ligaments is not necessary when the knee is centrally stabilized with the augmentation device. These results indicate that successful repair of the anterior cruciate ligament is frequently possible when enhanced with an augmentation device.

Successful Arthroscopic Primary Repair of a Chronic Anterior Cruciate Ligament Tear 11 Years Following Injury

“…A possible explanation for these unpredictable results followed in 1991, when Sherman et al reported an extensive subgroup analysis of primary ACL repair outcomes and found that better results were associated with proximal tears and excellent tissue quality. Several other studies also noted better results in the subset of patients with proximal tears [9,11,14,23,37]. Other factors that could have contributed to these mixed results were invasive surgery (i.e., arthrotomy) and the postoperative regimen (i.e., immobilization for 6 weeks) [18].…”

Anterior cruciate ligament reconstruction with alternative tibial tunnel: early results after accelerated weight-bearing

“…One of the reasons for this precautious rehabilitation programme was the publication of animal studies demonstrating an extremely long period for maturation of the repaired ACL [2,11]. Several authors, however, stressed the advantages of a rigorous rehabilitation programme after ACL reconstruction which allows early activity of patients without any protection [8,9,10,[14][15][16]. Both the above mentioned reports and good personal experiences with protected accelerated mobilisation [13] made us decide to treat patients after ACL reconstruction with accelerated, unprotected mobilisation.…”

Update vordere Kreuzbandruptur

“…Insbesondere Marshall et al [19] propagierten direkte Nähte des VKBStumpfes, allerdings mit deutlich reduzierten Ergebnissen. Die Notwendigkeit einer intraartikulären Stabilisierung des Kniegelenks erkannten bereits Paessler et al [21] Die anteriore Translation im Rolimeter-Lachman-Test konnte durch DIS nach 1 Jahr von 7,6 mm auf 1,7 mm sowie durch die VKB-Plastik von 8,4 mm auf 1,4 mm reduziert werden. Der numerische Vorteil der VKB-Plastik war hierbei nicht signifikant und auch der Vergleich des Tegner-, Lysholm-und IKDC-Scores erbrachte vergleichbare Ergebnisse.…”