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

List, Jelle P. van der; DiFelice, Gregory S.

doi:10.1007/s11420-016-9530-8

Cited by 20 publications

(11 citation statements)

References 40 publications

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“…Magnetic resonance imaging is a valuable tool that allows the anatomical integrity of the ACL to be assessed by visualizing the entire anatomy from femoral origin to tibial insertion [17]. Multiple previous studies have evaluated the role of postoperative MRI after ACL reconstruction both after bone-patellar tendon bone (BPTB) and hamstrings grafts [14,17]. However, the graft maturation process is a distinctly different biological situation than the healing of the native ACL that has been repaired, and thus it is felt that the relevance to primary ACL repair is limited.…”

Section: Discussionmentioning

confidence: 99%

“…In the last several years, some studies on ACL repair have shown good to excellent results with a failure rate ranging from 7% to 15% of cases [9][10][11][12][13]. Most articles recommend surgery within 4 weeks from injury; however, there is a wide variety of delay until treatment, including at least one case report of a patient treated 11 years after injury [14]. Since the renewal of interest in ACL primary repair has only been recent, there has been little investigation regarding MRI evaluation after ACL primary repair [7,16,17].…”

Section: Introductionmentioning

confidence: 99%

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The healing potential of an acutely repaired ACL: a sequential MRI study

Ferretti¹,

Monaco²,

Annibaldi³

et al. 2020

J Orthop Traumatol

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Background: Recently, there has been renewed interest in primary anterior cruciate ligament (ACL) repair. The aim of this study is to report early clinical and radiological results of a consecutive series of acute ACL tears treated with arthroscopic primary ACL repair within 14 days from injury. Patients and methods: A consecutive series of patients with acute ACL tears were prospectively included in the study. Based on MRI appearance, ACL tears were classified into five types, and tissue quality was graded as good, fair, and poor. Patients with type I, II, and III tears and at least 50% of ACL tibial remnant intact with good tissue quality were ultimately included. Clinical outcomes were measured using the Tegner Lysholm Knee Scoring Scale (TLKSS), the Knee Injury and Osteoarthritis Outcome Score (KOOS), subjective and objective International Knee Documentation Committee (IKDC) scores, and KT-1000. Patients were also followed up with MRI evaluations at 1, 3, and 6 months postoperatively. ACL appearance was graded based on morphology (normal or abnormal) and signal intensity (isointense, intermediate, and hyperintense). Results: The mean TLKSS was 98.1, the mean subjective IKDC was 97.6, and the mean KOOS was 98.2. The objective IKDC score was A in eight of ten patients and B in two patients. KT-1000 measurements showed a maximum manual side-to-side difference of less than 2 mm in eight of ten patients, whereas two patients showed a difference of 3 mm. The morphology of the repaired ACL was normal (grade 1) at 1 month follow-up in ten of ten cases, and this appearance persisted at 3 and 6 months postoperatively. The signal intensity at 1 month postoperatively was graded as isointense (grade 1) in four of ten patients, intermediate (grade 2) in five of ten patients, and hyperintense (grade 3) in one of ten patients. At both 3 and 6 months postoperatively, the signal intensity was graded as isointense (grade 1) in nine of ten patients and intermediate (grade 2) in one of ten patients. Conclusions: Arthroscopic primary ACL repair performed acutely in a carefully selected group of patients with proximal ACL tears and good tissue quality showed good early clinical and radiological results.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The healing potential of an acutely repaired ACL: a sequential MRI study

Ferretti¹,

Monaco²,

Annibaldi³

et al. 2020

J Orthop Traumatol

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“…We consider that using a suspensory button device for the femoral fixation instead of knotless suture anchors 14 may have the following advantages: (1) avoidance of any physical or biomechanical reaction at the bone–ACL fiber interface because of absence of fixation devices at the aperture, and (2) in the case of revision surgery, easy removal of the hardware from both the tibial and femoral sides with a minimally invasive approach.…”

Section: Discussionmentioning

confidence: 99%

“…This is mainly seen in the subacute phase (i.e., between 2 weeks and 3 months 7 , 8 , 12 ) when the surgery is carried out but is also seen in chronic ACL ruptures if the ACL is scarred to the posterior cruciate ligament. 14 …”

Section: Surgical Techniquementioning

confidence: 99%

How to Succeed in Arthroscopic Anterior Cruciate Ligament Primary Repair? Step-by-Step Technique

Olmos

Sonnery‐Cottet

Barth

2019

Arthroscopy Techniques

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Historically, poor results of open primary repair of anterior cruciate ligament (ACL) injuries have been reported. It has recently been recognized that favorable outcomes of primary ACL repair are possible when selectively performed in patients with proximal tears and good tissue quality. Moreover, with arthroscopic technological advances, primary repair can be a valuable treatment option for patients with proximal tears. Preserving the native ACL has several advantages, including maintenance of native proprioceptive function and biology. The procedure is also minimally invasive and reduces the inflammatory reaction often seen in ACL reconstruction. Recently, it has been suggested that additional suture augmentation of the primary repair technique may be beneficial for protecting ligament healing during early range of motion. In this Technical Note, we present the step-by-step surgical technique of arthroscopic primary repair using a femoral suspensory device with suture augmentation.

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“…These conditions are usually seen in the acute phase (i.e. first 3 months 4 , 5 , 6 ), but can be seen in the chronic setting if the ACL is reattached to the posterior cruciate ligament 8 ( Table 1 ).…”

Section: Surgical Techniquementioning

confidence: 99%

Arthroscopic Primary Anterior Cruciate Ligament Repair With Suture Augmentation

List

DiFelice

2017

Arthroscopy Techniques

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Historically, poor results of open primary repair of anterior cruciate ligament (ACL) injuries have been reported. In hindsight, however, appropriate patient selection (i.e. proximal tears and good tissue quality) was not performed, because it has recently been recognized that good outcomes of primary ACL repair are possible when selectively performed in patients with proximal tears and good tissue quality. Moreover, with modern-day advances, arthroscopic primary repair can be an excellent treatment option for patients with proximal tears. Preserving the native ACL has several advantages, including maintaining native proprioceptive function and biology. The procedure is also minimally invasive and prevents the need for formal ACL reconstruction. Recently, it has been suggested that additional suture augmentation of the primary repair technique may be beneficial for protecting ligament healing during early range of motion. In this Technical Note, we present the surgical technique of arthroscopic primary repair with suture augmentation for patients with proximal ACL tears.

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

Cited by 20 publications

References 40 publications

The healing potential of an acutely repaired ACL: a sequential MRI study

The healing potential of an acutely repaired ACL: a sequential MRI study

How to Succeed in Arthroscopic Anterior Cruciate Ligament Primary Repair? Step-by-Step Technique

Arthroscopic Primary Anterior Cruciate Ligament Repair With Suture Augmentation

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