Jelle P van der List1, Gregory S DiFelice2. 1. Orthopaedic Trauma Service, Department of Orthopaedic Surgery, Hospital for Special Surgery, NewYork-Presbyterian, Weill Medical College of Cornell University, New York, NY, United States. Electronic address: vanderlistj@hss.edu. 2. Orthopaedic Trauma Service, Department of Orthopaedic Surgery, Hospital for Special Surgery, NewYork-Presbyterian, Weill Medical College of Cornell University, New York, NY, United States.
Abstract
INTRODUCTION: Recently, there has been a resurgence of interest in primary anterior cruciate ligament (ACL) repair. The procedure is less invasive than ACL reconstruction, yet studies assessing early postoperative course are lacking. Goal therefore was to assess postoperative range of motion (ROM), complications and operative times following primary repair and compare this to the gold standard of reconstruction. METHODS: A retrospective study was performed for which 52 repair and 90 reconstruction patients could be included. Patients were examined at one week and one, three and six months. Rehabilitation protocol consisted of early ROM and was equal for both groups. Outcomes were compared using independent t-tests and chi-square tests, and reported in mean±standard deviation. RESULTS: Repair had more ROM than reconstruction patients at one week (89°±18 vs. 61°±21, p<0.01) and one month (125°±14 vs. 116°±18, p < 0.01) postoperatively. Fewer repair patients had 90° ROM at one week (23% vs. 84%, p<0.01), and more repair patients had full ROM at one month (57% vs. 30%, p<0.01). Treatment of meniscal lesions, but not chondral lesions, influenced ROM. Trends towards fewer complications (2% vs. 9%, p=0.19) and infections (0% vs. 6%, p=0.20) were noted following primary repair, and the procedure was significantly shorter. CONCLUSIONS: Following primary repair, patients had better ROM, and trends towards fewer complications than reconstruction. Primary repair is a safe, brief procedure with early ROM and low complication rates.
INTRODUCTION: Recently, there has been a resurgence of interest in primary anterior cruciate ligament (ACL) repair. The procedure is less invasive than ACL reconstruction, yet studies assessing early postoperative course are lacking. Goal therefore was to assess postoperative range of motion (ROM), complications and operative times following primary repair and compare this to the gold standard of reconstruction. METHODS: A retrospective study was performed for which 52 repair and 90 reconstruction patients could be included. Patients were examined at one week and one, three and six months. Rehabilitation protocol consisted of early ROM and was equal for both groups. Outcomes were compared using independent t-tests and chi-square tests, and reported in mean±standard deviation. RESULTS: Repair had more ROM than reconstruction patients at one week (89°±18 vs. 61°±21, p<0.01) and one month (125°±14 vs. 116°±18, p < 0.01) postoperatively. Fewer repair patients had 90° ROM at one week (23% vs. 84%, p<0.01), and more repair patients had full ROM at one month (57% vs. 30%, p<0.01). Treatment of meniscal lesions, but not chondral lesions, influenced ROM. Trends towards fewer complications (2% vs. 9%, p=0.19) and infections (0% vs. 6%, p=0.20) were noted following primary repair, and the procedure was significantly shorter. CONCLUSIONS: Following primary repair, patients had better ROM, and trends towards fewer complications than reconstruction. Primary repair is a safe, brief procedure with early ROM and low complication rates.
Authors: Sufian S Ahmad; Gregory S Difelice; Jelle P van der List; Atesch Ateschrang; Michael T Hirschmann Journal: Knee Surg Sports Traumatol Arthrosc Date: 2018-12-07 Impact factor: 4.342
Authors: Martin Meister; Jonathan Koch; Felix Amsler; Markus P Arnold; Michael T Hirschmann Journal: Knee Surg Sports Traumatol Arthrosc Date: 2017-09-22 Impact factor: 4.342