title: Dynamic intraligamentary stabilisation: initial experience with treatment of acute ACL ruptures.
abstract: OBJECTIVE
  The purpose of this study was to report the experience of dynamic intraligamentary stabilisation (DIS) using the Ligamys device for the treatment of acute ruptures of the anterior cruciate ligament (ACL).
  
  
  METHODS
  Between March 2011 and April 2012, 50 patients (34 men and 16 women) with an acute rupture of the ACL underwent primary repair using this device. The mean age of the patients was 30 years (18 to 50). Patients were evaluated for laxity, stability, range of movement (ROM), Tegner, Lysholm, International Knee Documentation Committee (IKDC) and visual analogue scale (VAS) scores over a follow-up period of two years.
  
  
  RESULTS
  At final follow-up, anteroposterior translation differed from the normal knee by a mean of 0.96 mm (-2 mm to 6 mm). Median (interquartile range) IKDC, Tegner, Lysholm and VAS scores were 98 (95 to 100), 6 (5 to 7), 100 (98 to 100) and 10 (9 to 10), respectively. Pre-injury Tegner activity levels were reached one year post-operatively. A total of nine patients (18%) required a secondary intervention; five developed instability, of whom four underwent secondary hamstring reconstructive surgery, and five required arthroscopic treatment for intra-articular impingement due to scar tissue which caused a fixed flexion deformity. In addition, 30 patients (60%) required removal of the tibial screw.
  
  
  CONCLUSIONS
  While there was a high rate of secondary interventions, 45 patients (90%) retained their repaired ACL two years post-operatively, with good clinical scores and stability of the knee.
  
  
  CONCLUSIONS
  Dynamic intraligamentary stabilisation presents a promising treatment option for acute ACL ruptures, eliminating the need for ACL reconstruction. Cite this article: Bone Joint J 2016;98-B:793-8.
authors.affiliation: University Hospital of Bern, Inselspital, Switzerland.
authors.forename: S
authors.initials: S
authors.lastname: Kohl
authors.affiliation: University Hospital of Bern, Inselspital, Switzerland.
authors.forename: D S
authors.initials: DS
authors.lastname: Evangelopoulos
authors.affiliation: University Hospital of Bern, Inselspital, Switzerland.
authors.forename: M O
authors.initials: MO
authors.lastname: Schär
authors.affiliation: University Hospital of Bern, Inselspital, Switzerland.
authors.forename: K
authors.initials: K
authors.lastname: Bieri
authors.affiliation: University Hospital of Bern, Inselspital, Switzerland.
authors.forename: T
authors.initials: T
authors.lastname: Müller
authors.affiliation: University Hospital of Bern, Inselspital, Switzerland.
authors.forename: S S
authors.initials: SS
authors.lastname: Ahmad
mesh_terms: D000293:Adolescent; D000328:Adult; D059549:Anterior Cruciate Ligament Reconstruction / Q000295:instrumentation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000601:surgery; D007719:Knee Joint / Q000601:surgery; D065466:Lysholm Knee Score; D008297:Male; D008875:Middle Aged; D009984:Orthopedic Fixation Devices; D011183:Postoperative Complications; D012086:Reoperation; D012421:Rupture / Q000601:surgery; D064232:Visual Analog Scale; D055815:Young Adult
keywords: ACL healing; ACL repair; ACL rupture; ACL suture; Ligamys