Primary Anterior Cruciate Ligament Repair Using Suture Tape Augmentation: A Case Series of 29 Patients With Minimum 2-Year Follow-Up

Burton, Denver A.; Schaefer, Eliana J.; Shu, Henry T.; Bodendorfer, Blake M.; Argintar, Evan

doi:10.1016/j.arthro.2020.11.034

Cited by 29 publications

(30 citation statements)

References 46 publications

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“…Suture anchors were used in two studies for the femoral fixation of proximal tears [ 42 , 62 ]. Interestingly, all studies published since 2019 applied an internal brace as suture tape augmentation [ 18 , 25 , 42 , 62 ], a technique which is also used to repair ACL ruptures [ 5 , 19 , 20 , 67 ]. This highlight how the promising results of modern ACL repair have sparked a renewed interest in PCL repair as well.…”

Section: Discussionmentioning

confidence: 99%

Posterior cruciate ligament repair seems safe with low failure rates but more high level evidence is needed: a systematic review

et al. 2023

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Purpose To discuss recent literature on posterior cruciate ligament (PCL) repair and report on the clinical and radiological outcomes. Methods A systematic review was conducted according to the PRISMA guidelines. In August 2022, three databases (PubMed, Scopus, and Cochrane Library) were searched for studies on PCL repair by two independent reviewers. Articles published between January 2000 and August 2022 focussing on the clinical and/or radiological outcomes, following PCL repair, were included. Patient demographic data, clinical evaluations, patient‑reported outcome measures, post-operative complications and radiological outcomes were extracted. Results Nine studies met the inclusion criteria, covering 226 patients with a mean age ranging from 22.4 to 38.8 years and mean follow-up periods ranging from 14 to 78.6 months. Seven studies (77.8%) were level IV and two studies (22.2%) were level III. Arthroscopic PCL repair was performed in four studies (44.4%) while the remaining five studies (55.6%) described open PCL repair. In four studies (44.4%) additional suture augmentation was applied. Arthrofibrosis affected a combined total of 24 patients (11.7%; range 0–21.0%) making it the most common complication and the overall failure rate was 5.6%, ranging from 0 to 15.8%. Two studies (22.2%) performed post-operative MRI and confirmed PCL healing. Conclusion This systematic review indicates that PCL repair can be a safe procedure with an overall failure rate of 5.6%, ranging from 0% to 15.8%. However, more high quality research is necessary before widespread clinical implementation is warranted. Level of Evidence IV.

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Section: Discussionmentioning

confidence: 99%

Posterior cruciate ligament repair seems safe with low failure rates but more high level evidence is needed: a systematic review

et al. 2023

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“…5 The authors should be commended for their efforts in designing and carrying out this study, as no previous study has evaluated the biomechanical performance of suture tape augmentation of BTB ACL reconstructions. The Inter-nalBrace (Arthrex, Naples, FL) concept has gained traction in a variety of applications for the knee, including medial collateral and posteromedial corner reconstruction and repair, [6][7][8][9] lateral collateral ligament repair, 10 posterior cruciate ligament avulsion repair 11 and ACL repair, [12][13][14][15] and reconstruction. 16,17 For ACL reconstruction, the technique consists of using either suture or suture tape fixed at the femoral and tibial ACL footprints to allow for independent tensioning to back up the separately tensioned ACL reconstruction.…”

Section: See Related Article On Page 3335mentioning

confidence: 99%

Editorial Commentary: The Anterior Cruciate Ligament May Be Safer Wearing a Suture Tape Augmentation Seat Belt: Click It or Ticket

Bodendorfer

2021

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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“…Other studies on proximal ACL repair have corroborated this finding, revealing favorable patient-reported outcomes, durable ligament stability, and low graft-rupture rates over a short to midterm follow-up. 1,7,8,10,24 Compared with proximal ACL tears, ACL midsubstance tears are much more complicated and difficult to treat, both biologically and mechanically. First, ACL midsubstance tears have a ruptured stump that is much less widely vascularized than its proximal counterpart.…”

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confidence: 99%

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confidence: 99%

Platelet-Rich Fibrin–Augmented Gap-Bridging Strategy in Rabbit Anterior Cruciate Ligament Repair

et al. 2023

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Background: We assessed the efficacy of a novel platelet-rich fibrin (PRF)–augmented repair strategy for promoting biological healing of an anterior cruciate ligament (ACL) midsubstance tear in a rabbit model. The biological gap-bridging effect of a PRF scaffold alone or in combination with rabbit ligamentocytes on primary ACL healing was evaluated both in vitro and in vivo. Hypothesis: A PRF matrix can be implanted as a provisional fibrin-platelet bridging scaffold at an ACL defect to facilitate functional healing. Study Design: Controlled laboratory study. Methods: The biological effects of PRF on primary rabbit ligamentocyte proliferation, tenogenic differentiation, migration, and tendon-specific matrix production were investigated for treatment of cells with PRF-conditioned medium (PRFM). Three-dimensional (3D) lyophilized PRF (LPRF)–cell composite was fabricated by culturing ligamentocytes on an LPRF patch for 14 days. Cell-scaffold interactions were investigated under a scanning electron microscope and through histological analysis. An ACL midsubstance tear model was established in 3 rabbit groups: a ruptured ACL was treated with isolated suture repair in group A, whereas the primary repair was augmented with LPRF and LPRF-cell composite to bridge the gap between ruptured ends of ligaments in groups B and C, respectively. Outcomes—gross appearance, magnetic resonance imaging, and histological analysis—were evaluated in postoperative weeks 8 and 12. Results: PRFM promoted cultured ligamentocyte proliferation, migration, and expression of tenogenic genes (type I and III collagen and tenascin). PRF was noted to upregulate cell tenogenic differentiation in terms of matrix production. In the 3D culture, viable cells formed layers at high density on the LPRF scaffold surface, with notable cell ingrowth and abundant collagenous matrix depositions. Moreover, ACL repair tissue and less articular cartilage damage were observed in knee joints in groups B and C, implying the existence of a chondroprotective phenomenon associated with PRF-augmented treatment. Conclusion: Our PRF-augmented strategy can facilitate the formation of stable repair tissue and thus provide gap-bridging in ACL repair. Clinical Relevance: From the translational viewpoint, effective primary repair of the ACL may enable considerable advancement in therapeutic strategy for ACL injuries, particularly allowing for proprioception retention and thus improved physiological joint kinematics.

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Primary Anterior Cruciate Ligament Repair Using Suture Tape Augmentation: A Case Series of 29 Patients With Minimum 2-Year Follow-Up

Cited by 29 publications

References 46 publications

Posterior cruciate ligament repair seems safe with low failure rates but more high level evidence is needed: a systematic review

Posterior cruciate ligament repair seems safe with low failure rates but more high level evidence is needed: a systematic review

Editorial Commentary: The Anterior Cruciate Ligament May Be Safer Wearing a Suture Tape Augmentation Seat Belt: Click It or Ticket

Platelet-Rich Fibrin–Augmented Gap-Bridging Strategy in Rabbit Anterior Cruciate Ligament Repair

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