Good clinical scores, no evidence of excessive anterior tibial translation, a high return to sport rate and a low re-injury rate is observed following anterior cruciate ligament reconstruction using autologous hamstrings augmented with suture tape

Jay R Ebert; Peter Edwards; Peter T Annear

doi:10.1007/s00402-023-04835-9

Good clinical scores, no evidence of excessive anterior tibial translation, a high return to sport rate and a low re-injury rate is observed following anterior cruciate ligament reconstruction using autologous hamstrings augmented with suture tape

Arch Orthop Trauma Surg. 2023 Aug;143(8):5207-5220. doi: 10.1007/s00402-023-04835-9. Epub 2023 Mar 15.

Authors

Jay R Ebert^{1

2

3}, Peter Edwards⁴, Peter T Annear^{5

6}

Affiliations

¹ The School of Human Sciences (Exercise and Sport Science, M408), The University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia. jay.ebert@uwa.edu.au.
² HFRC Rehabilitation Clinic, 117 Stirling Highway, Nedlands, WA, 6009, Australia. jay.ebert@uwa.edu.au.
³ Perth Orthopaedic & Sports Medicine Research Institute, West Perth, WA, 6005, Australia. jay.ebert@uwa.edu.au.
⁴ School of Allied Health, Curtin University, Perth, WA, Australia.
⁵ Perth Orthopaedic & Sports Medicine Research Institute, West Perth, WA, 6005, Australia.
⁶ Perth Orthopaedic and Sports Medicine Centre, West Perth, WA, 6005, Australia.

Abstract

Introduction: Augmented anterior cruciate ligament reconstruction (ACLR) techniques have been proposed to reduce the high reported re-injury rates and low rates of return to sport (RTS). This study reports clinical outcomes, RTS and re-injury rates in patients undergoing ACLR using autologous hamstrings augmented with suture tape.

Materials and methods: A total of 53 patients were prospectively recruited, undergoing ACLR using hamstrings with suture tape augmentation, combined with a structured rehabilitation programme. Outcomes were collected to 24 months, including patient-reported outcome measures (PROMs), KT-1000 measurements, peak isokinetic knee strength and a four hop test battery. Limb Symmetry Indices (LSIs) were calculated for performance measures, whilst RTS rates, re-tears and re-operations were presented.

Results: There were no significant side-to-side differences in anterior tibial translation between the operated and non-operated knees at 6 months (p = 0.433), with no increase (p = 0.841) in side-to-side anterior tibial translation from 6 to 24 months. At 24 months, 98.0% of patients demonstrated normal (< 3 mm) or near normal (3-5 mm) side-to-side differences. LSIs for peak knee extensor torque (p < 0.0001) and the single (p = 0.001), triple (p = 0.001) and triple crossover (p < 0.0001) hop tests for distance significantly improved. All PROMs significantly improved (p < 0.0001), with 70.2% and 85.7% of patients actively participating in pivoting sports at 12 and 24 months, respectively. Three patients underwent secondary procedures for meniscal symptoms. One patient suffered an ACL re-tear (17 months), with no further ipsilateral or contralateral injuries.

Conclusion: ACLR with suture tape augmentation demonstrated no evidence of excessive anterior tibial translation, high-scoring PROMs, sound performance scores, a high rate of RTS and low re-injury rate.

Keywords: Anterior cruciate ligament reconstruction; Augmentation; Clinical outcomes; Knee function; Re-tears; Return to sport.

MeSH terms

Anterior Cruciate Ligament Injuries* / surgery
Anterior Cruciate Ligament Reconstruction* / methods
Humans
Knee Joint / surgery
Quadriceps Muscle / surgery
Reinjuries* / surgery
Return to Sport
Sutures

Grants and funding

US-00010/Arthrex