Recovery of ACL function after dynamic intraligamentary stabilization is resultant to restoration of ACL integrity and scar tissue formation.

Ateschrang, Atesch; Ahmad, Sufian; Stöckle, Ulrich; Schroeter, Steffen; Schenk, Willem; Ahrend, Marc Daniel (2018). Recovery of ACL function after dynamic intraligamentary stabilization is resultant to restoration of ACL integrity and scar tissue formation. Knee surgery, sports traumatology, arthroscopy, 26(2), pp. 589-595. Springer 10.1007/s00167-017-4656-x

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PURPOSE Dynamic intraligamentary stabilization (DIS) is recognized as a ligament preserving technique for the treatment of acute anterior cruciate ligament (ACL) injuries. The aim of this study was to assess the integrity and morphology of the recovered ACL after DIS repair. METHODS The cohort comprised 47 patients with an acute proximal ACL rupture undergoing DIS repair. All patients underwent diagnostic arthroscopy after a minimum postoperative interval of 6 months for semi-quantitative evaluation of ACL integrity, function and scar tissue formation. Tegner, Lysholm and International Knee Documentation Committee (IKDC) scores as well as objective anteroposterior (ap) translation were assessed at 6 weeks, 3-, 6-  and 12 months postoperatively. RESULTS Full restoration of the ACL volume was affirmed in 30 (63.8%) patients and two-third restoration in 13 (27.7%). Hypertrophic scar formation was observed in 23 (48.9%) patients. Forty-four patients (93.6%) demonstrated sufficient ACL tensioning intraoperatively upon anterior stress. At final follow-up, the median Tegner activity level was 5.5 (3-10), Lysholm and IKDC scores were 100 (64-100) and 94 (55-100) points, respectively. The mean ap-translation differed from the normal knee by 2.1 ± 2.2 mm. Deficient ACL recovery was noted in four patients (8.5%), none of which required secondary reconstructive surgery. CONCLUSION The results demonstrate that clinical recovery of ACL function after DIS repair is resultant to both restoration of ACL volume and scar tissue formation. Factors influencing the degree of scar tissue formation need further investigation to enable future attempts of guiding a balanced biological healing response. LEVEL OF EVIDENCE IV.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Orthopaedic Surgery

UniBE Contributor:

Ahmad, Sufian

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0942-2056

Publisher:

Springer

Language:

English

Submitter:

Lilianna Bolliger

Date Deposited:

16 Apr 2018 10:55

Last Modified:

25 Apr 2018 12:36

Publisher DOI:

10.1007/s00167-017-4656-x

PubMed ID:

28741153

Uncontrolled Keywords:

ACL ACL reconstruction Dynamic intraligamentary stabilization Ligamys Reconstruction Repair Rupture Stabilisation Tear

BORIS DOI:

10.7892/boris.110740

URI:

https://boris.unibe.ch/id/eprint/110740

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