Suture Tape Augmentation of Anterior Cruciate Ligament Reconstruction Increases Biomechanical Stability: A Scoping Review of Biomechanical, Animal, and Clinical Studies

Mackenzie, Christopher; Huntington, Lachlan S; Tulloch, Scott

doi:10.1016/j.arthro.2021.12.036

Cited by 40 publications

(22 citation statements)

References 47 publications

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“…Our findings support the limited available clinical data on this topic, which has demonstrated a mix of equivocal and improved results for suture tape augmentation in terms of PROMs and failure rates. 9,29,37,40,46 Our study is the first to present medium-term follow-up data, and despite a longer follow-up, demonstrates a low failure rate.…”

Section: Discussionmentioning

confidence: 57%

Outcomes of Anterior Cruciate Ligament Reconstruction With Independently Tensioned Suture Tape Augmentation at 5-Year Follow-up

Wilson,

Kennedy,

MacLeod

et al. 2023

Am J Sports Med

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Background: Reconstruction using autograft remains the gold standard surgical treatment for anterior cruciate ligament (ACL) injuries. However, up to 10% to 15% of patients will suffer a graft failure in the future. Cadaveric studies have demonstrated that the addition of suture tape augmentation to ACL autograft constructs can increase graft strength and reduce elongation under cyclical loading. Purpose/Hypothesis: This study aimed to investigate the clinical outcomes and rerupture rates after ACL reconstruction (ACLR) with suture tape augmentation. We hypothesized that augmentation with suture tape would lead to lower rerupture rates. Study Design: Case series; Level of evidence, 4. Methods: Patients undergoing primary ACLR using hamstring or patellar tendon autografts augmented with suture tape between 2015 and 2019 were recruited prospectively. Patients with multiligament injuries or a concomitant lateral extra-articular procedure were excluded. Patients were observed in person for 6 months, and patient-reported outcome measures (PROMs) were collected at 2 and 5 years postoperatively. All patients were contacted, and records were reviewed to determine the incidence of graft failure. PROMs collected were as follows: Knee injury and Osteoarthritis Outcome Score (KOOS), Veterans RAND 12-Item Health Survey (VR-12), Tegner and Marx activity scores, and visual analog scale for pain (VAS). Results: A total of 97 patients, with a mean age of 34.7 (±13.4) years, were included (76% men; 52 hamstring and 45 patellar tendon grafts). The mean graft diameter was 8 (±1) mm. There was 1 rerupture (1.1%) out of the 90 patients who were contactable at a mean of 5 years postoperatively. Median KOOS scores at 2 years were as follows: Pain, 94; Symptoms, 86; Activities of Daily Living, 99; Sport and Recreation, 82; and Quality of Life, 81. The postoperative scores were significantly higher than the preoperative scores ( P < .001). The VR-12 Physical score improved from 43 preoperatively to 55 at 2 years and remained at 56 at 5 years. The VAS pain, Tegner, and Marx scores were 0, 6, and 9, respectively, at 2 years postoperatively. There was no difference in PROMs between graft types. Conclusion: This study demonstrates encouraging results of suture tape augmentation of autograft ACLR for both hamstring and patellar tendon grafts. The failure rate of 1.1% at a mean follow-up of 5 years is lower than published rates for reconstruction, and PROMs results are satisfactory. The technique is safe to use and may permit a return to the preinjury sporting level with a lower chance of reinjury.

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Section: Discussionmentioning

confidence: 57%

Outcomes of Anterior Cruciate Ligament Reconstruction With Independently Tensioned Suture Tape Augmentation at 5-Year Follow-up

Wilson,

Kennedy,

MacLeod

et al. 2023

Am J Sports Med

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“…This effect was supported by biomechanical studies demonstrating that ACLR with STA improved graft stiffness and failure load compared to ACLR alone, reducing tibial displacement under anterior load ( Torres et al, 2022 ). In the clinical scenario, the STA technique has been used for ACLR in several sports medicine centers worldwide in recent 5 years ( Mackenzie et al, 2022 ). However, the clinical superiority of ST-augmented grafts remained unclear, and a summary of available literature on clinical outcomes of ACLR with STA is lacking.…”

Section: Introductionmentioning

confidence: 99%

Suture tape augmentation, a novel application of synthetic materials in anterior cruciate ligament reconstruction: A systematic review

Zheng

Cao

Song

et al. 2023

Front. Bioeng. Biotechnol.

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Objective: Suture tape (ST) is a common synthetic material in the repairing surgery of soft tissue. Recently, ST augmentation (STA) technique has been described as a novel way to improve the mechanical property of grafts in the anterior cruciate ligament (ACL) reconstruction (ACLR). However, the clinical outcomes of ACLR using ST-augmented grafts have not been clarified. This systematic review aimed to summarize the specific technique of STA and evaluate the clinical outcomes after ACLR with STA.Methods: A electronic search of PubMed and Embase databases with a manual search of Google Scholar was performed to identify studies that reported the clinical outcomes of ACLR with STA. Each included study was abstracted regarding the study features, patient data, surgical information, and outcome measures.Results: Nine studies were included, representing 314 knees in 314 patients undergoing ACLR with STA. Technically, ST was fixed independently from grafts in six studies and along with grafts in two studies. Most studies applied an equal or slightly less tension on ST than ACL graft. Clinically, significant improvements were found in the Lysholm, IKDC, and KOOS scores after a mean follow-up of 16.7 months. Physical examinations of 220 patients showed significant restoration of knee stability at the final follow-up. 59 of 80 (73.8%) patients returned to preinjury sports level at a minimum 2 year follow-up. Six of 266 (2.3%) patients had a graft failure during the first 2 years postoperatively. The use of ST was significantly associated with better Tegner scores and a trend toward significantly higher rates of return to sport compared to standard ACLR. No significant difference was found in most subjective scores, knee laxity, and graft failures between ACLR with or without STA.Conclusion: ACLR with STA achieved overall favorable clinical outcomes. Patients using ST-augmented grafts were seemingly associated with better sports performance compared to standard ACLR. But ACLR with STA was not superior to ACLR alone in most functional scores, knee stability measures, and graft failure rates. A tension equal to or slightly less than the ACL graft should be carefully applied on ST during fixation to avoid stress shielding of the graft.

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“… 14 Tape augmentation increases the strength of the graft complex, demonstrating greater load to failure and reduced elongation. 15 However, suture or tape augmentation techniques describe incorporating the suture or tape into a separate post from the ACL graft, such as with tibial anchors 16 or tibial suspensory devices. 17 , 18 These techniques introduce the potential for graft and suture tension mismatch and increase surgical cost due to need for an additional anchor/implant.…”

Section: Introductionmentioning

confidence: 99%

Postless Tape Augmentation for Anterior Cruciate Ligament (ACL) Reconstruction

Alrabaa¹,

Padaki²,

Kannan³

et al. 2022

Arthroscopy Techniques

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Suture Tape Augmentation of Anterior Cruciate Ligament Reconstruction Increases Biomechanical Stability: A Scoping Review of Biomechanical, Animal, and Clinical Studies

Cited by 40 publications

References 47 publications

Outcomes of Anterior Cruciate Ligament Reconstruction With Independently Tensioned Suture Tape Augmentation at 5-Year Follow-up

Outcomes of Anterior Cruciate Ligament Reconstruction With Independently Tensioned Suture Tape Augmentation at 5-Year Follow-up

Suture tape augmentation, a novel application of synthetic materials in anterior cruciate ligament reconstruction: A systematic review

Postless Tape Augmentation for Anterior Cruciate Ligament (ACL) Reconstruction

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