2017 ISAKOS Biennial Congress ePoster #1102

 

Return to Sport in Anterior Cruciate Ligament Reconstruction Using either Synthetic Devices or Hamstring Autografts: A Cohort Study of 10 Years Period

Tianwu Chen, MD, Shanghai CHINA
Shiyi Chen, MD, PhD, Prof., Shanghai CHINA

Huashan Hospital, Fudan University, Shanghai, CHINA

FDA Status Not Applicable

Summary

Over seventy patients returned to preinjury level after ACL reconstruction, in which synthetics showed early return compared with hamstring autografts.

Abstract

Purpose

To investigate the 1) return to sport after anterior cruciate ligament (ACL) reconstruction using either synthetic devices or hamstring autografts; and 2) potential influence factors

Methods

Data were retrospectively anaylsed in patients accepting ACL reconstruction in our institution during July 2004 and December 2007. Inclusion criteria included, 1) cases of ACL reconstruction with competitive sport ability pre-injury, 2) using Ligament Advanced Reinforcement System (LARS) or hamstring autografts. Exclusion criteria included, 1) previous knee surgery/revision, 2) multi-ligament injury, 3) chondral injury (Outerbridege > II), 4) sub-total/total meniscectomy. The data of Tegner Activity Score (TAS), 2000 International Knee Documentation Committee (IKDC) subjective score, Lysholm Knee Scaling Score (LKSS) at 6 months, 1 year, and 5 years postoperative were reviewed. At 10 years postoperative, physical and radiographic examination were fulfilled in patients as well as patients-reported questionnaires [2000 IKDC, TAS, LKSS, Knee Injury and Osteoarthritis Outcome Score (KOOS), ACL- Return to Sports after Injury scale (ACL-RSI)].

Outcome:
The mean follow-up time was 120 ± 8 months. A total of 86 cases (27 LARS and 59 auto-hamstring) were investigated and the mean age was 25.6±5.7 (LARS) and 26.9±7.2 (auto-hamstring) years old. The rate of return to pre-injury level was 77.8% (21/27) in LARS cases and 72.9% (43/59) in auto-hamstring cases, (P=0.791). In the LARS cases and auto-hamstring cases, the rate of joining in competitive sports was 29.6% (8/27) and 3.4% (2/59) at 6 months postoperative, (P=0.002); 70.3% (19/27) and 37.3% (22/59) at 1 year postoperative, (P=0.005); 66.7% (18/27) and 59.3% (35/59) at 5 years postoperative, (P=0.635); 44.4% (12/27) and 28.8% (17/59) at 10 years postoperative, (P=0.219). At 10 years follow-up, 29 cases joined in competitive sports and 40 cases joined in recreational sports. No significant difference was found between competitive and recreational cases with regard to objective IKDC and radiographic outcome. TAS (P<0.001), KOOS subscale Quality of Life (P=0.001), and ACL-RSI (P<0.001) was statistical different between them.

Conclusion

Over seventy patients returned to pre-injury level after ACL reconstruction, in which synthetics showed early return compared with hamstring autografts. Eighty percent of cases maintained sports activity at 10 years postoperative, and psychological influence on activity level should be noticed.