Acute Anterior Cruciate Ligament Rupture: Repair or Reconstruction?
Many clinicians have discussed the pros and cons of a surgical reconstruction or conservative care for an anterior cruciate ligament (ACL) rupture. In recent years, there has also been a renewed interest in re-assessing suture repair of a ruptured ACL. Therefore, Hoogeslag and colleagues completed a randomized trial to examine patient-reported, clinical, and radiological outcomes among young adults receiving a dynamic augmented ACL repair or ACL reconstruction. The authors recruited people between 18 and 30 years of age, with a confirmed primary ACL rupture, with a Tegner Activity Scale score of 5 or more, and without concomitant injuries. A total of 48 participants randomly received either a dynamic augmented ACL repair or an ACL reconstruction. Following surgery, all participants received similarly structured rehabilitation. Participants completed evaluations at baseline, and then at 3-, 6-, 9-, 12-, and 24-months post-surgery. Outcomes were assessed with a physical examination, the International Knee Documentation Committee 2000 (IKDC), Knee Injury and Osteoarthritis Outcome Score (KOOS), Tegner score, and a visual analog scale to assess patient satisfaction. Overall, during the 2-year follow-up period, there was no difference between the augmented ACL repair group and the ACL reconstruction group. There was a trend that the repair group had fewer re-ruptures (repair: 9%, reconstruction: 19%) but more surgeries for reasons other than re-rupture (repair: 21%, reconstruction 14%; e.g., residual synovitis, extension deficit, cyclops lesions).
Incidence and Outcome after Revision Anterior Cruciate Ligament Reconstruction
ACL Reconstruction Provides Not So Good Long-Term Outcomes
Has There Been Any Change in ACL Injury Rates?
Altered Lower Extremity Biomechanics Following an ACL Injury and Surgery May Increase the Risk of Reinjury