Comparison between two techniques for surgical repair of the acutely torn anterior cruciate ligament. A prospective, randomized follow-up study of 48 patients.
This prospective, randomized study was designed to evaluate the early outcome of ACL repair with biologic or synthetic augmentation. Forty-eight consecutive patients with an acute proximal rupture of the ACL were included. The repairs in 22 patients were augmented with the Kennedy Ligament Augmentation Device (LAD), while 26 patients received a repair augmented with an autologous bone-patellar tendon-bone graft. All patients followed a standard rehabilitation protocol. Follow-up evaluations at 1 and 2 years postoperatively were based on the Tegner activity level, Lysholm functional score, clinical instability tests and KT-1000 arthrometer measurements. There were no significant differences in activity level or functional score between the LAD and patellar tendon groups at the 2-year follow-up. Ten patients in the LAD group (46%) sustained reruptures of the ACL and LAD at the 2-year follow-up, while two patients in the patellar tendon group had a KT1000 side difference of 4 mm or more. However, none of the patients in the patellar tendon group had a positive pivot shift. During the first postoperative year, 8 patients (31%) in the patellar tendon and 2 in the LAD group (9%) underwent arthroscopic debridement for correction of an extension deficit. These range of motion complications were probably related to the anterior placement of the tibial tunnel and the conservative rehabilitation protocol. Because of the unacceptable high incidence of reruptures in the LAD group, we concluded that the augmentation technique with the LAD is unacceptable.
Grøntvedt
T
T
Department of Orthopaedics, Trondheim University Hospital, Norway.
Engebretsen
L
L
D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007718:Knee Injuries / Q000503:physiopathology / Q000601:surgery*; D007719:Knee Joint; D008297:Male; D011446:Prospective Studies; D019736:Prostheses and Implants; D016059:Range of Motion, Articular; D012421:Rupture; D013710:Tendons / Q000637:transplantation; D014182:Transplantation, Autologous