Five year results of the first ten ACL patients treated with dynamic intraligamentary stabilisation

Eggli, Stefan; Röder, Christoph; Perler, Gosia; Henle, Philipp (2016). Five year results of the first ten ACL patients treated with dynamic intraligamentary stabilisation. BMC musculoskeletal disorders, 17(1), p. 105. BioMed Central 10.1186/s12891-016-0961-7

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Abstract BACKGROUND: In recent years, the scientific discussion has focused on new strategies to enable a torn anterior cruciate ligament (ACL) to heal into mechanically stable scar tissue. Dynamic intraligamentary stabilization (DIS) with LigamysTM was first performed in a pilot study of 10 patients. The purpose of the current study was to evaluate the five year results of this group. METHODS: Inclusion criteria were an ACL rupture not older than 14 days, patient age <45 years, no previous surgery on the injured knee, and regular participation in sports requiring pivoting of the knee joint. Ten consecutive patients (eight males, two females) underwent surgery between August 2009 and February 2010. They were treated by DIS employing an internal stabilizer to keep the unstable knee in a posterior translation, combined with microfracturing and platelet-rich fibrin induction at the rupture site to promote self-healing. Postoperative clinical outcome [Tegner, Lysholm, International Knee Documentation Committee (IKDC), visual analogue scale patient satisfaction score] and assessment of knee laxity was performed at 3, 6, 12, 24 and 60 months. RESULTS: Median patient age at time of surgery was 23.3 years (range 19-41 years). The median time to surgery was 10 days (range 5-13 days). The rupture was located in the middle third of the ligament in seven patients and in the proximal third in three patients. Eight patients showed additional meniscal lesions, which were surgically treated in six patients. Eight of the ten patients reached the five-years follow-up. Median Lysholm score was 100 (range 90-100); the IKDC score was 98.9 (range 79.3-100); Tegner score was 5.5 (range 5-7); median Lachman difference to the other side was 2 mm (range 0-4 mm). Median patient satisfaction was 10 points (range 8-10 pts.). Four of the ten patients underwent metal removal (tibial implant component) after ACL healing and a consequently stable knee joint. Two patients suffered from a re-rupture at 5 months and 4.2 years after surgery and were treated with a bone-tendon-bone ACL graft. CONCLUSIONS: Dynamic intraligamentary stabilization in ten active patients with a fresh ACL rupture showed a 5-years survival rate of 80 %. At the last follow-up all patients with a functionally healed ACL showed excellent outcomes and satisfaction with regards to the treatment result.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute for Evaluative Research into Orthopaedic Surgery
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)

UniBE Contributor:

Eggli, Stefan; Röder, Christoph; Perler, Gosia and Henle, Philipp

Subjects:

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

ISSN:

1471-2474

Publisher:

BioMed Central

Language:

English

Submitter:

Doris Kopp Heim

Date Deposited:

15 Dec 2016 14:17

Last Modified:

15 Dec 2016 16:31

Publisher DOI:

10.1186/s12891-016-0961-7

PubMed ID:

26920141

Additional Information:

Eggli and Röder contributed equally to this work.

BORIS DOI:

10.7892/boris.91601

URI:

https://boris.unibe.ch/id/eprint/91601

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