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ACL Repair Versus ACL Reconstruction in Chronic Lesions

Gian Luigi Canata, MD
ITALY

ACL Repair Versus ACL Reconstruction in Chronic Lesions

Gian Luigi Canata, MD, ITALY Valentina Casale, MD, ITALY

Centre of Sports Traumatology - Koelliker Hospital, Turin, ITALY

2021 Congress ePoster Presentation Not yet rated

Anatomic Location

Knee

Anatomic Structure

Ligaments

Ligaments

ACL

Treatment / Technique

Arthroscopy

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Summary: Recently, a renewed interest in acute primary anterior cruciate ligament (ACL) repair has raised, but even chronic lesions may have similar characteristics. This retrospective study compared mid- to very long-term results after ACL repair of proximal chronic lesions to a control group of ACL reconstructions.

All ACL surgeries performed by a single surgeon between January 2008 and December 2015 were retrospectively evaluated.
After applying the inclusion and exclusion criteria, two different groups were identified.
Patients with a chronic, proximal ACL lesion and still a good ligamentous quality underwent an ACL transosseous repair with cortical fixation and formed Group A (n=31). They were compared to a control group (Group B, n=31) undergoing an ACL reconstruction with a bone-to-bone patellar tendon autograft. The reconstruction procedures were selected in close temporal proximity to each repair intervention.
At a mean follow-up of 81 months (range, 28-122 months), the failure rates were 9,67% (3/31) and 6,45% (2/31), respectively.
Clinical and functional outcomes were measured in terms of anterior drawer test, Lachman's test, Jerk test, KT1000 side-to-side difference, subjective International Knee Documentation Committee (IKDC) Scoring, Knee injury and Osteoarthritis Outcome Score (KOOS), and Tegner activity level scale.
Group B (n=29) showed significantly better results in the KOOS grade (p=0,036) compared to group A (n=28).
No further significant differences were found in gender, postoperative anterior drawer test, Lachman's test, Jerk test, KT1000 side-to-side difference, subjective International Knee Documentation Committee (IKDC) Scoring, and Tegner activity level scale.
Both the two techniques showed good outcomes and low failure rates. These results were approximately comparable, except for the postoperative KOOS values, which were better in the reconstruction group.
Primary repair of chronic, proximal ACL lesions is an effective alternative to ligament reconstruction, even though further research is needed to improve the selection of ideal candidates for repair.

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ACL Repair Versus ACL Reconstruction in Chronic Lesions

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ACL Repair Versus ACL Reconstruction in Chronic Lesions

ACL Repair Versus ACL Reconstruction in Chronic Lesions