Dynamic intraligamentary stabilization of anterior cruciate ligament repair: hardware removal has no effect on knee laxity at 2-year follow-up.

Häberli, Janosch; Bieri, Kathrin Susan; Aghayev, Emin; Eggli, Stefan; Henle, Philipp (2019). Dynamic intraligamentary stabilization of anterior cruciate ligament repair: hardware removal has no effect on knee laxity at 2-year follow-up. Archives of orthopaedic and trauma surgery, 139(5), pp. 639-644. Springer 10.1007/s00402-019-03113-x

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INTRODUCTION

Dynamic intraligamentary stabilization (DIS) stabilizes the knee joint during anterior cruciate ligament (ACL) healing. After 6 months, tibial hardware removal is offered to the patients if local discomfort at the implant site is present.

AIM

This study compared knee laxity and functional scores 2 years after DIS between patients with and without hardware removal. It is hypothesized that it does not affect ACL healing.

MATERIALS AND METHODS

The study retrospectively analyzed prospectively collected data from 173 patients with either hardware removal (n = 47) or no additional intervention (n = 126). Inverse probability of treatment weighting using the propensity score was applied to balance the groups for baseline characteristics. The primary outcome was the side-to-side difference in knee laxity measured with the rolimeter at manual maximum force (Δ-Lachman). Secondary outcomes were the pivot-shift test and subjective scores.

RESULTS

Mean age was 34 years in both groups, and female gender was 47% (hardware removal group) and 50% (control group), respectively. No significant differences were found for Δ-Lachman (p = 0.09), pivot-shift test (p = 0.41), and subjective scores (p > 0.10) two years after DIS.

CONCLUSION

Knee laxity 2 years after DIS in patients with tibial hardware removal and patients without hardware removal was not significantly different. The groups were also similar regarding all the assessed functional scores. This study confirms the hypothesis that the healing ACL resumes its stabilizing role, and the hardware can be removed beginning 6 months after surgery without adverse consequences for joint stability.

LEVEL OF EVIDENCE

Case-control study, Level III.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)

UniBE Contributor:

Bieri, Kathrin, Aghayev, Emin

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

0936-8051

Publisher:

Springer

Language:

English

Submitter:

Doris Kopp Heim

Date Deposited:

23 Jan 2019 09:15

Last Modified:

18 Jan 2023 00:25

Publisher DOI:

10.1007/s00402-019-03113-x

PubMed ID:

30649589

Additional Information:

Authors Häberli and Bieri contributed equally to this work.

Uncontrolled Keywords:

ACL Dynamic intraligamentary stabilization Hardware removal Knee laxity Lachman Ligamys

BORIS DOI:

10.7892/boris.125039

URI:

https://boris.unibe.ch/id/eprint/125039

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