Rate of Revision Surgery and Associated Risk Factors After Primary Arthroscopic ACL Repair With Additional Suture Augmentation

Overview

Journal Orthop J Sports Med

Specialty Orthopedics

Date 2024 Jun 3

PMID 38827140

Authors

Kristian Nikolaus Schneider

Christoph Theil

Georg Gosheger

Jan Frederic Weller

Anna Goth

Georg Ahlbaeumer

Affiliations

Soon will be listed here.

Abstract

Background: Recent studies have suggested promising patient-reported outcomes after primary anterior cruciate ligament (ACL) repair with additional suture augmentation (SA).

Purpose: To evaluate the risk for revision surgery and identify patient- and injury-related risk factors after ACL repair with SA in a large patient cohort subject to strict patient selection.

Study Design: Case-control study; Level of evidence, 3.

Methods: Included were 86 patients (61 female; 93% follow-up rate) who underwent arthroscopic ACL repair with SA between January 2017 and March 2019 by a single surgeon and had a minimum follow-up of 24 months. Patients were selected for surgery with regard to time to surgery (preferably on the day of injury), tear pattern (limited to Sherman types 1 and 2), and tissue quality (intact synovial coverage). Postoperatively, the patients who needed revision surgery were identified and compared with patients who did not undergo revision surgery, using the Mann-Whitney test for nonparametric analysis and the Student test for parametric analysis. A Kaplan-Meier analysis was performed to investigate the survival rate of the ACL repair.

Results: A total of 9 patients (10%; median age, 48 years; interquartile range [IQR], 27-50 years) underwent revision surgery at 12 months postoperatively (IQR, 8-25 months). The median follow-up of patients without revision surgery was 35 months (IQR, 33-44 months). The revision-free survival rate was 97% (95% CI, 93%-100%) after 1 year, 93% (95% CI, 88%-98%) after 2 years, and 90% (95% CI, 83%-97%) after 4 years. Patient-related factors-such as sex ( = .98), age at surgery ( = .459), body mass index ( = .352), and preinjury level of sports ( = .53)-had no significant impact on the survival rate of the ACL repair. Injury-related factors-such as concomitant injuries of the medial ( = .860) and lateral menisci ( = .414) and the medial ( = .801) and lateral collateral ligaments ( = .534) or same-day surgery compared with a delay of surgery of up to 18 days ( = .277)-had no significant impact on the survival rate of the ACL repair.

Conclusion: The revision rate of primary ACL repair with SA at a 2-year follow-up was 10%. Patient- and injury-related factors were not associated with the survival rate of the ACL repair.

Citing Articles

Higher Unilateral Muscle Imbalance at the Contralateral Knee 6 Months after Anterior Cruciate Ligament Reconstruction.

de Dicastillo L, Villalabeitia J, Delgado D, Jorquera C, Andrade R, Espregueira-Mendes J Sports (Basel). 2024; 12(9).

PMID: 39330721 PMC: 11435792. DOI: 10.3390/sports12090243.

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