Arthroscopic primary repair of proximal anterior cruciate ligament tears: outcomes of the first 56 consecutive patients and the role of additional internal bracing

2019 ◽  
Vol 27 (1) ◽  
pp. 21-28 ◽  
Author(s):  
Anne Jonkergouw ◽  
Jelle P. van der List ◽  
Gregory S. DiFelice
Keyword(s):  
Anterior Cruciate Ligament ◽  
Primary Repair ◽  
Cruciate Ligament ◽  
Internal Bracing ◽  
Anterior Cruciate ◽  
Cruciate Ligament Tears

Is There a Role for Internal Bracing and Repair of the Anterior Cruciate Ligament? A Systematic Literature Review

2017 ◽  
Vol 46 (9) ◽  
pp. 2291-2298 ◽  
Author(s):  
Carola F. van Eck ◽  
Orr Limpisvasti ◽  
Neal S. ElAttrache
Keyword(s):  
Anterior Cruciate Ligament ◽  
Success Rate ◽  
Platelet Rich Plasma ◽  
Primary Repair ◽  
Cruciate Ligament ◽  
Young Patients ◽  
Acl Repair ◽  
Internal Bracing ◽  
Electronic Database Search ◽  
Anterior Cruciate

Background: Renewed interest has arisen in arthroscopic anterior cruciate ligament (ACL) repair techniques. Hypothesis: ACL repair with or without some form of internal bracing could lead to good outcomes in a carefully selected subset of patients. Study Design: Systematic review. Methods: An electronic database search was performed to identify 89 papers describing preclinical and clinical studies on the outcome of ACL repair. Results: Proximal ACL tear patterns showed a better healing potential with primary repair than distal or midsubstance tears. Some form of internal bracing increased the success rate of ACL repair. Improvement in the biological characteristics of the repair was obtained by bone marrow access by drilling tunnels or microfracture. Augmentation with platelet-rich plasma was beneficial only in combination with a structural scaffold. Skeletally immature patients had the best outcomes. Acute repair offered improved outcomes with regard to load, stiffness, laxity, and rerupture. Conclusion: ACL repair may be a viable option in young patients with acute, proximal ACL tears. The use of internal bracing, biological augmentation, and scaffold tissue may increase the success rate of repair.

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