No Difference In Stability, Proprioception And Neuromuscular Control After Suture-Tape Augmented ACL Repair Versus ACL Reconstruction Using Hamstring Autografts In Young, Active Population.

No Difference In Stability, Proprioception And Neuromuscular Control After Suture-Tape Augmented ACL Repair Versus ACL Reconstruction Using Hamstring Autografts In Young, Active Population.

Adrian Góralczyk, MD, POLAND Paulina Zalewska, BSC, POLAND Szczepan Piszczatowski, PhD, POLAND Krzysztof Hermanowicz, POLAND Tomasz Guszczyn, PhD, POLAND

Institute of Biomedical Engineering, Bialystok University of Technology, Białystok, POLAND


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Anatomic Location

Anatomic Structure

Diagnosis / Condition

Treatment / Technique

Ligaments

ACL

Sports Medicine


Summary: With limited indications, primary ACL repair with suture tape augmentation and ACLR with hamstring autografts yield similar results in term of stability, proprioception and neuromuscular control in a population of young, active patients


Purpose

To determine if anterior cruciate ligament repair with suture tape augmentation (IB) provides better results in stability, proprioception and neuromuscular control in comparison to ACL reconstruction (ACLR) with hamstrings autograft.

Methods

Patients with unilateral ACL injury treated with IB or ACLR with hamstrings autograft were enrolled in the study. The ACL repair was performed only in patients with proximal ACL avulsion diagnosed on MRI scans with a time limit up to 3 weeks from injury to surgery and an adequate ACL remnant quality. Other patients were scheduled for ACLR. Anterior tibial translation (ATT) in 30˚ and 90˚ of knee flexion was measured with Rolimeter. The joint position sense (JPS) test was performed in 30˚ and 60˚ of knee flexion using Biodex System 4Pro. The time-synchronized motion capture system and surface electromyography set were used during forward landing tasks to assess dynamic knee valgus and semitendinosus (ST) and biceps femoris (BF) activities. Comparisons between both techniques and operated versus contralateral healthy knees were performed.

Results

The study groups involved 28 patients after ACLR (10F, 18M; 21.8 ± 4.8 years) and 20 patients after IB procedure (8 F, 12M; 25.8 ± 10.5 years) with the average follow-up 30 ± 18 months and 28± 15 months respectively. The ATT did not differ significantly between operated groups. In 30˚ of knee flexion ATT for ACLR group was significantly higher in operated than in contralateral knee (5.8±2.4mm vs 4.3±1.3mm, p= 0.012). The JPS test and dynamic knee valgus assessment did not reveal significant differences. The ACLR group presented significantly higher ST ( ACLR-op 46.0±20.3% MVC vs ACLR-nop 33.7±18.3 %MVC, p= 0.048) and BF (ACLR-op 49.9±16.6%MVC vs ACLR-nop 40.3±12.6 %MVC, p=0.048) activity comparing operated to contralateral knee in dynamic tasks.

Conclusion

Primary ACL repair with suture tape augmentation and ACLR with hamstring autografts yield similar results in term of stability, proprioception and neuromuscular control in a population of young, active patients