Changes in gait pattern and early functional results after ACL repair are comparable to those of ACL reconstruction

Schliemann, Benedikt; Glasbrenner, Johannes; Rosenbaum, Dieter; Lammers, Katharina; Herbort, Mirco; Domnick, Christoph; Raschke, Michael J.; Kösters, Clemens

doi:10.1007/s00167-017-4618-3

Cited by 54 publications

(108 citation statements)

References 24 publications

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“…Application of the search strategy yielded 19 studies eligible for inclusion in the systematic review. Five studies [35][36][37][38][39] were comparative, including 1 Level I study, 35 3 Level II studies, [36][37][38] and 1 Level III study. 39 Although the study by Henle et al 36 was a comparative study, it did not compare the clinical results of ACL repair with reconstruction.…”

Section: Study Selectionmentioning

confidence: 99%

“…A total of 1002 patients who underwent arthroscopic primary ACL repair formed the overall population evaluated in this systematic review. These patients underwent ACL repair with either suture anchor repair (SAR) (n ¼ 158), 37,39,42,46,48,49 dynamic intraligamentary stabilization with Ligamys (DIS Ligamys) (n ¼ 779), 35,36,40,41,43,44,[50][51][52][53] bridge-enhanced ACL repair technique (i.e., BEAR) (n ¼ 10), 38 suture pullout repair (n ¼ 13), 45 or augmented ACL repair using suture tape reinforcement with internal brace (IB) (Internal Brace Ligament Augmentation Repair; Arthrex, Naples, FL) 47 (n ¼ 42).…”

Section: Arthroscopic Primary Acl Repair Techniquesmentioning

confidence: 99%

“…Using the Cochrane Risk of Bias Tool, we graded the included randomized clinical trial by Schliemann et al 35 to be of fair quality. The MINORS criteria scores for other included non-randomized studies are reported in Table 1.…”

Section: Quality Assessment Of Included Studiesmentioning

confidence: 99%

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Clinical Outcomes of Arthroscopic Primary Anterior Cruciate Ligament Repair: A Systematic Review from the Scientific Anterior Cruciate Ligament Network International Study Group

Kandhari

Vieira

Ouanezar

et al. 2020

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Purpose: To perform a systematic review of contemporary studies reporting clinical outcomes of primary anterior cruciate ligament (ACL) repair to determine whether these studies demonstrate any significant benefit of ACL repair and whether there is evidence of a deterioration of mid-term outcomes as seen in historical data. Methods: A systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. A PubMed search using the keywords "repair" AND "Anterior Cruciate Ligament" was performed (limits: English language, publication date between January 1, 2014, and January 13, 2019). All identified studies reporting clinical outcomes of arthroscopic ACL repair were included. Critical appraisal was conducted using the Cochrane Risk of Bias Tool for Randomized Clinical Trials and the Methodological Index for Non-Randomized Studies. Basic parameters of each study including population characteristics, repair technique, physical examination findings, and clinical outcome scores were recorded and evaluated. Results: Nineteen eligible studies were identified (including 5 comparative studies). None of the comparative studies showed any significant difference between repair and reconstruction groups with respect to International Knee Documentation Committee (IKDC), Lysholm, Tegner, side-to-side laxity difference, Lachman, pivot shift tests, or graft rupture rates. Four non-comparative studies reported outcomes at medium-to long-term follow up (range of mean follow up 43.3-79 months) with a mean Lysholm score between 85.3 and 100, mean IKDC subjective score between 87.3 and 100, and mean Tegner activity score between 5 and 7. Conclusions: Comparative studies identified no significant differences between ACL repair and reconstruction with respect to Lysholm, IKDC, side-to-side laxity difference, pivot shift grade, or graft rupture rates. However, these studies had major limitations including small numbers and short durations of follow up. Case series demonstrated that excellent outcomes can be achieved at medium-to long-term follow up with the SAR technique. Level of Evidence: IV; Systematic review of Level II to IV investigations. See related article on page 613 H istorical results of open primary repair of the anterior cruciate ligament (ACL) have been characterized in the literature by good initial clinical outcomes, 1-6 with a significant deterioration at midterm follow-up and high rates of additional surgery (64%), including reoperation for ACL reconstruction (13%

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Section: Study Selectionmentioning

confidence: 99%

Section: Arthroscopic Primary Acl Repair Techniquesmentioning

confidence: 99%

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Clinical Outcomes of Arthroscopic Primary Anterior Cruciate Ligament Repair: A Systematic Review from the Scientific Anterior Cruciate Ligament Network International Study Group

Kandhari

Vieira

Ouanezar

et al. 2020

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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“…Any injury of muscle and joints will lead to gait disorder. The injury of ACL will not only affect the gait stability of patients, but also changes the biomechanical environment of the knee joint. Osteoarthritis and meniscus injury are two types of complications that are commonly found in ACL injury patients.…”

Section: Discussionmentioning

confidence: 99%

Biomechanical Evaluation of Preoperative Rehabilitation in Patients of Anterior Cruciate Ligament Injury

Qie

et al. 2020

Orthopaedic Surgery

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Objectives: To investigate the biomechanical characteristics of patients with anterior cruciate ligament (ACL) injury by gait analysis, surface electromyography (SEMG), and proprioception test, and provide rehabilitation suggestions according to the results.Methods: In this retrospective cohort study, 90 adults with unilateral ACL injury, ranging in age from 19 to 45 years (66 men and 24 women, average age: 30.03 AE 7.91) were recruited for this study form May 2018 to July 2019. They were divided into three groups according to the time after the injury: group A (3-week to 1.5-month), group B (1.5-month to 1 year), and group C (more than 1 year). The SEMG signals were collected from the bilateral rectus femoris (RF), vastus medialis (VM), and vastus lateralis (VL) and the root mean square (RMS) were used to assess muscular activity. SEMG were used to analyze muscles function, gait analysis was used to evaluate the walking stability, balance and location assessment were used to analyze the proprioception.Results: Through the comparison between bilateral limbs, all muscles strength shown decreased (RF: 239.94 AE 129.70 vs 364.81 AE 148.98, P = 0.001; VM: 298.88 AE 175.41 vs 515.79 AE 272.49, P = 0.001; VL:389.54 AE 157.97 vs 594.28 AE 220.31, P < 0.001) and the division of proprioception became larger (tandem position: 7.79 AE 1.57 vs 6.33 AE 1.49, P = 0.001; stance with one foot: 8.13 AE 0.84 vs 7.1 AE 0.57, P = 0.003; variance of 30 : 6.96 AE 3.15 vs 4.45 AE 1.67, P = 0.03; variance of 60 : 4.64 AE 3.38 vs 2.75 AE 1.98, P = 0.044) in the injured side when compared to the non-injured and 26 gait parameters were shown difference in group A. In group B, the muscle strength of VL shown decreased (VL: 381.23 AE 142.07 vs 603.9 AE 192.72, P < 0.001) and the division of location of 30 became larger (7.62 AE 4.98 vs 4.33 AE 3.24, P = 0.028) in the injured side when compared to the non-injured side and there were eight gait parameters that showed differences. In group C, the muscle strength and proprioception showed no differences and only 16 gait parameters showed differences between the bilateral limbs. Conclusion:The results proved the deterioration of proprioception in 30 of injured side will not recover and non-injury side and will become worse after 1 year from the injury; among the VL, VM, and RF, the recovery rate of VL is the slowest and bilateral straight leg raising (SLR) (30 ) is the best way to train it; the gait stability will be worse after 1 year from the injury. Therefore, we suggest that the training for proprioception in 30 and VL are important for the rehabilitation, and the ACL reconstruction should be performed within 1 year. AE 62.75 205.55 AE 86.79 0.158 216.15 AE 61.52 196.07 AE 44.06 0.152 VL 382.7 AE 136.09 439.62 AE 119.74 0.091 287.18 AE 106.76 374.9 AE 103.22 0.002* 363.7 AE 98.95 408.1 AE 83.12 0.065 243.77 AE 91.62 281.47 AE 84.63 0.103 258.88 AE 79.23 231.9 AE 91.51 0.227 248.63 AE 86.51 217.35 AE 79.63 0.151 Group C RF 269.16 AE 74.43 310.44 AE 93.12 0.063 213.53 AE 92.05 267.27 AE 139.1 0...

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“…In den weiteren Follow-ups nach 6 Monaten und 1 Jahr nivellierten sich die Unterschiede in der Aktivitätsmessung [23].…”

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Update vordere Kreuzbandruptur

Herbort

Glasbrenner

Schliemann

et al. 2017

Trauma Berufskrankh

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Changes in gait pattern and early functional results after ACL repair are comparable to those of ACL reconstruction

Abstract: I.

Cited by 54 publications

References 24 publications

Clinical Outcomes of Arthroscopic Primary Anterior Cruciate Ligament Repair: A Systematic Review from the Scientific Anterior Cruciate Ligament Network International Study Group

Clinical Outcomes of Arthroscopic Primary Anterior Cruciate Ligament Repair: A Systematic Review from the Scientific Anterior Cruciate Ligament Network International Study Group

Biomechanical Evaluation of Preoperative Rehabilitation in Patients of Anterior Cruciate Ligament Injury

Update vordere Kreuzbandruptur

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