Sufian S Ahmad1, Katharina Schürholz2, Emanuel F Liechti2, Michael T Hirschmann3, Sandro Kohl4, Frank M Klenke2. 1. BG Center for Trauma and Reconstructive Surgery, Eberhard-Karls University of Tübingen, Tübingen, Germany. sufian@ahmadortho.com. 2. Department of Orthopaedic Surgery and Traumatology, Inselspital, University of Bern, Bern, Switzerland. 3. Department of Orthopaedic Surgery and Traumatology, Kantonsspital Baselland (Bruderholz, Liestal, Laufen), Bruderholz, Switzerland. 4. Trauma Center Hirslanden Klinik, Zurich, Switzerland.
Abstract
PURPOSE: Primary repair of the anterior cruciate ligament (ACL) is regaining popularity. Long-term results are lacking. The purpose of the current study was to determine the survival of the primarily repaired ACL after dynamic intraligamentary stabilization. METHODS: Between 2011 and 2013, 57 patients with acute proximal ACL ruptures underwent DIS repair within 3 weeks from injury and were available for final follow-up at least 5 years postoperatively. Failure as an end point was defined as conversion to ACL reconstruction, failure to restore stability with persisting laxity side-to-side laxity of > 5 mm or a late-traumatic re-rupture or loss of stability. Kaplan-Meier survival analysis was performed. RESULTS: Kaplan-Meier survival analysis demonstrated an overall survival of 70.0% (standard error SE 6.6%) at 74 months follow-up. Patients performing competitive sports prior to injury demonstrated an inferior long-term ACL survival of 56.4% (SE 11.6%). Patients performing recreational sport activities demonstrated a survival rate of 79.2% (SE 7.7%). The one factor demonstrating a direct influence on failure after adjustment was a high-pre-injury level of physical (odds ratio 4.0 confidence interval 1.0-15.8, p = 0.04). CONCLUSION: The minimum 5 years survival rate after primary ACL repair using this technique was 70%. This value dropped to 56% in highly active patients performing competitive sports. Patients not suffering failure of repair demonstrated adequate restoration of knee laxity and high satisfaction. This study not only underlines the potential of ACL repair, but also highlights the danger of the procedure if strict patient selection is not appreciated. LEVEL OF EVIDENCE: Level IV.
PURPOSE: Primary repair of the anterior cruciate ligament (ACL) is regaining popularity. Long-term results are lacking. The purpose of the current study was to determine the survival of the primarily repaired ACL after dynamic intraligamentary stabilization. METHODS: Between 2011 and 2013, 57 patients with acute proximal ACL ruptures underwent DIS repair within 3 weeks from injury and were available for final follow-up at least 5 years postoperatively. Failure as an end point was defined as conversion to ACL reconstruction, failure to restore stability with persisting laxity side-to-side laxity of > 5 mm or a late-traumatic re-rupture or loss of stability. Kaplan-Meier survival analysis was performed. RESULTS: Kaplan-Meier survival analysis demonstrated an overall survival of 70.0% (standard error SE 6.6%) at 74 months follow-up. Patients performing competitive sports prior to injury demonstrated an inferior long-term ACL survival of 56.4% (SE 11.6%). Patients performing recreational sport activities demonstrated a survival rate of 79.2% (SE 7.7%). The one factor demonstrating a direct influence on failure after adjustment was a high-pre-injury level of physical (odds ratio 4.0 confidence interval 1.0-15.8, p = 0.04). CONCLUSION: The minimum 5 years survival rate after primary ACL repair using this technique was 70%. This value dropped to 56% in highly active patients performing competitive sports. Patients not suffering failure of repair demonstrated adequate restoration of knee laxity and high satisfaction. This study not only underlines the potential of ACL repair, but also highlights the danger of the procedure if strict patient selection is not appreciated. LEVEL OF EVIDENCE: Level IV.
Authors: Martin Faschingbauer; S Hacker; A Seitz; L Dürselen; F Boettner; H Reichel Journal: Knee Surg Sports Traumatol Arthrosc Date: 2020-04-18 Impact factor: 4.342
Authors: Ezgi Bakirci; Karin Tschan; Rahel D May; Sufian S Ahmad; Barbara Kleer; Benjamin Gantenbein Journal: Bone Joint Res Date: 2020-09-03 Impact factor: 5.853
Authors: Kenneth M Lin; Harmen D Vermeijden; Craig E Klinger; Lionel E Lazaro; Scott A Rodeo; Jonathan P Dyke; David L Helfet; Gregory S DiFelice Journal: J Exp Orthop Date: 2022-05-30
Authors: José F Vega; Gregory J Strnad; Isaac Briskin; Charles L Cox; Lutul D Farrow; Paul Fadale; David Flanigan; Michael Hulstyn; Peter B Imrey; Christopher C Kaeding; Brett D Owens; Paul Saluan; Rick Wright; Yi-Meng Yen; Kurt P Spindler Journal: Orthop J Sports Med Date: 2020-12-03
Authors: Sophie C Eberlein; Vanessa Rodriguez; Andreas Hecker; Katharina Schürholz; Sufian S Ahmad; Frank M Klenke Journal: J Exp Orthop Date: 2022-08-08
Authors: Johannes Glasbrenner; Michael J Raschke; Christoph Kittl; Elmar Herbst; Christian Peez; Thorben Briese; Philipp A Michel; Mirco Herbort; Clemens Kösters; Benedikt Schliemann Journal: Am J Sports Med Date: 2022-08-25 Impact factor: 7.010