scholarly journals Prognostic Factors for Patient-Reported Outcomes at 32 to 37 Years After Surgical or Nonsurgical Management of Anterior Cruciate Ligament Injury

2021 ◽  
Vol 9 (8) ◽  
pp. 232596712110215
Author(s):  
Stephanie Filbay ◽  
Christer Andersson ◽  
Håkan Gauffin ◽  
Joanna Kvist
Keyword(s):  
Anterior Cruciate Ligament ◽  
Prognostic Factors ◽  
Cruciate Ligament ◽  
Knee Laxity ◽  
Acl Injury ◽  
Acl Repair ◽  
Extension Deficit ◽  
Anterior Cruciate ◽  
Flexion And Extension

Background: Knowledge to inform the identification of individuals with a poor long-term prognosis after anterior cruciate ligament (ACL) injury is limited. Identifying prognostic factors for long-term outcomes after ACL injury may inform targeted interventions to improve outcomes for those with a poor long-term prognosis. Purpose: To determine whether ACL treatment (early augmented or nonaugmented ACL repair plus rehabilitation, rehabilitation alone, or rehabilitation plus delayed ACL reconstruction [ACLR]) and 4-year measures (quadriceps and hamstrings strength, single-leg hop, knee laxity, flexion and extension deficit, self-reported knee function, activity level) are prognostic factors for patient-reported outcomes at 32 to 37 years after acute ACL injury. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 251 patients aged 15 to 40 years with acute ACL rupture between 1980 and 1985 were allocated to early ACL repair (augmented or nonaugmented) plus rehabilitation or to rehabilitation alone, based on birth year. One hundred ninety of 234 completed 32- to 37-year follow-up questionnaires (response rate, 81%); 18 people were excluded, resulting in 172 patients available for analysis (mean age, 59 ± 6 years; 28% female). Potential prognostic factors assessed 4 years after ACL injury were ACL treatment (early ACL repair, rehabilitation alone, or delayed ACLR), isokinetic quadriceps and hamstrings strength, single-leg hop performance, knee flexion and extension deficit, knee laxity, Tegner activity scale, and Lysholm score. Outcomes included Knee injury and Osteoarthritis Outcome Score (KOOS) subscales and the Anterior Cruciate Ligament Quality of Life (ACL-QOL) measure. Linear regression adjusted for age, sex, baseline meniscal injury, and contralateral ACL injury was used to assess potential prognostic factors for 32- to 37-year outcomes. Multiple imputation accounted for missing data. Results: A fair/poor Lysholm score (vs excellent/good) at 4 years was a prognostic factor for worse KOOS Pain (adjusted regression coefficient, −12 [95% confidence interval (CI), −19 to −4]), KOOS Symptoms (−15 [95% CI, −23 to −7]), KOOS Sport and Recreation (−19 [95% CI, −31 to −8]), and ACL QOL (−9 [95% CI, −18 to −1]) scores. A 4-year single-leg hop limb symmetry index <90% was a prognostic factor for worse KOOS Pain (adjusted regression coefficient, −9 [95% CI, −17 to −1]) and ACL QOL (−13 [95% CI, −22 to −3]) scores at long-term follow-up. A lower activity level, delayed ACLR, and increased knee laxity were prognostic factors in the crude analysis. Rehabilitation alone versus early repair, quadriceps and hamstring strength, and flexion and extension deficit were not related to 32- to 37-year outcomes. Conclusion: Reduced self-reported knee function and single-leg hop performance 4 years after ACL injury were prognostic factors for worse 32- to 37-year outcomes. Estimates exceeded clinically important thresholds, highlighting the importance of assessing these constructs when managing individuals with ACL injuries. Registration: NCT03182647 ( ClinicalTrials.gov identifier).

Measuring the force perception in knee flexor/ extensor muscles in patients with anterior cruciate ligament injury and healthy subjects

2021 ◽  
pp. 1-8
Author(s):  
Bahram Amirshakeri ◽  
Minoo Khalkhali Zavieh ◽  
Mandana Rezaei ◽  
Hakimeh Adigozali
Keyword(s):  
Anterior Cruciate Ligament ◽  
Healthy Subjects ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Injured Limb ◽  
Knee Flexor ◽  
Force Perception ◽  
Extensor Muscles ◽  
Anterior Cruciate ◽  
Flexion And Extension

BACKGROUND: Force perception as a contributor to the neuromuscular control of the knee joint may be altered after anterior cruciate ligament (ACL) injury. OBJECTIVE: This study aimed to compare the force perception accuracy in the knee joints of patients with ACL injury and healthy subjects. METHODS: Twenty-six patients with ACL injury and 26 healthy subjects participated in this case-control study. Participants were asked to produce 50% of the maximum voluntary isometric contraction of the knee muscles as a target force and reproduce it in their limbs in flexion and extension directions. RESULTS: There were significant interactions between group and condition as well as group, condition, and limb in the force perception error respectively (P< 0.05). The highest amount of error was seen in the contralateral limb of the ACL injury group when the reference force was produced in the injured limb (P< 0.05). CONCLUSION: The findings revealed that the force perception accuracy in the knee flexor/extensor muscles of individuals with ACL injury is impaired. Moreover, error is most evident when the patient produces force in the injured limb and replicates it in the uninjured limb in both flexion and extension directions. Therefore, the rehabilitation programs should encompass neuromuscular training in both quadriceps and hamstrings after ACL injury.

scholarly journals Primary ACL Repair vs Reconstruction: Investigating the Current Conventional Wisdom

2018 ◽  
Vol 6 (6_suppl3) ◽  
pp. 2325967118S0004 ◽  
Author(s):  
Gabriella Bucci ◽  
Michael Begg ◽  
Kevin Pillifant ◽  
Steven B. Singleton
Keyword(s):  
Anterior Cruciate Ligament ◽  
Sports Medicine ◽  
Cruciate Ligament ◽  
Conventional Wisdom ◽  
Acl Repair ◽  
Arthroscopic Technique ◽  
Anterior Cruciate ◽  
Injured Knee

BACKGROUND: “Why try to convert other collagen substitutes into ligament if the original can be preserved?” said Sherman1. Nowadays, reconstruction became the gold standard treatment for ACL injuries. Despite current treatment, secondary knee osteoarthritis has been described in more than 70% of the injured patients after 10 years follow up.2 Recent studies have reported that tears involving the proximal ACL have an intrinsic healing response. This response has been compared to the one observed in MCL injuries.3, 4. OBJECTIVE: The aim of this study is to initiate a scientific analysis of our experience in patients diagnosed with an acute, proximal ACL tear treated with a primary repair arthroscopic technique. We suggest the creation of a symposium that reconsiders the ACL repair as a tool for treatment, on a selected subset of patients. METHODS: We analyzed retrospectively the data of 12 consecutive patients diagnosed clinically and radiologically (MRI) with proximal ACL tears in our clinic. The inclusion criteria were: proximal ACL tear (type 1 tear in Sherman´s classification), good remaining ACL quality tissue and less than 3 months from injury. The mean age at time of surgery was 33 years (16 to 55). Patients included in this study are athletes either at an amateur or professional level. The technique consists of an anatomical reinsertion of native ACL by reinforcing the anteromedial and posterolateral bundles of the ACL with a series of high strength locking Bunnell-type sutures, moving up the ligament from distal to proximal with an arthroscopic suture passer. The normal ACL insertional footprint within the notch is then debrided to provide a bleeding surface for healing. Finally, the torn ligament is opposed to the native footprint using 1-2 absorbable anchors that recreate the anatomic bundle insertional sites of the native ACL. RESULTS: Associated injuries were found in 7 of the 12 patients, these included 4 knees with lateral and 1 with medial meniscal tear which were repaired in the same procedure. Also, one knee had a medial bucket handle tear, partial meniscectomy was performed, and one knee with a combined ACL/MCL injury in which the MCL was simultaneously repaired. In our ongoing series, were excluded patients that had sustained complex knee injuries with multi-ligament damage (except ACL/MCL injuries), those with ACL re-ruptures, and previous knee surgery with cartilage repair procedures. Validated functional outcomes scores were collected after a mean follow up of 20 months (14-26). For the IKDC subjective score 11 of 12 patients rated their knees as normal or nearly normal. Lachman and Pivot Shift was negative in all patients. Lysholm score postoperatively averaged 93.5 ± 7; preoperatively 48 ± 7. Tegner preinjury 7.5 ± 1.2 postinjury: 7 ± 1.4. The KT-1000 knee arthrometer, objectively measured < 3 mm of anterior tibial motion relative to the femur in the injured knee compared to the non-injured knee at all levels of force, including manual max tests, in all patients included in the study. No complications or further surgeries are reported up to date. CONCLUSION: The keys to success include: Proper patient selection, early intervention, all arthroscopic technique, appropriate suture control of the torn ACL fibers, and stable opposition to a bleeding bone surface at the native attachment site within the femoral notch. Long-term data is pending. However, basic science and early clinical studies are promising. REFERENCES Mark F. Sherman, MD, Lawernce Lieber, MD, Joel R. Bonamo, MD, Luga Podesta, MD, Ira Reiter, RPT., The long-term followup of primary anterior cruciate ligament repair, 1991, The American Journal of Sports Medicine, Vol. 19, No 3. Martha M. Murray, MD. Current Status and Potential for Primary ACL Repair. 2009. Clin Ssports Med. Duy Tan Nguyen, Tamara H. Ramwadhdoebe, Cor P. van der Hart, Leendert Blankervoort, Paul Peter Tak, Cornelis Niek van Dijk., Intrinsic Healing Response of the Human Anterior Cruciate Ligament: An Histological Study of Reattached ACL Remnants, 2014, Journal of Orthopaedic Research. Martha M. Murray, MD, Braden C. Fleming, Ph.D., Use of a Bioactive Scaffold to Stimulate ACL Healing Also Minimizes Post-traumatic Osteoarthritis after Surgery, 2014, American Journal of Sports Medicine. Primary ACL Repair vs Reconstruction: Investigating the Current Conventional Wisdom

scholarly journals Clinical Tests Can Be Used to Screen for Second Anterior Cruciate Ligament Injury in Younger Patients Who Return to Sport

2019 ◽  
Vol 7 (8) ◽  
pp. 232596711986300 ◽  
Author(s):  
Kate E. Webster ◽  
Julian A. Feller
Keyword(s):  
Anterior Cruciate Ligament ◽  
Odds Ratio ◽  
Cruciate Ligament ◽  
Return To Sport ◽  
Knee Laxity ◽  
Acl Injury ◽  
Anterior Knee Laxity ◽  
Anterior Cruciate ◽  
Clinical Measures ◽  
Anterior Knee

Background: Younger athletes have high rates of second anterior cruciate ligament (ACL) injury. Return-to-sport criteria have been proposed to enable athletes to make a safe return, but they frequently lack validation. It is unclear whether commonly recorded clinical measures can help to identify high-risk athletes. Purpose: To explore the association between commonly recorded clinical outcome measures and second ACL injury in a young, active patient group. Study Design: Cohort study; Level of evidence, 2. Methods: Included in this study were 329 athletes (200 males, 129 females) younger than 20 years at the time of first primary ACL reconstruction surgery who had subsequently returned to sport participation. Clinical examination included range of knee motion (passive flexion and extension deficits), instrumented anterior knee laxity, and single- and triple-crossover hop for distance. Patients also completed the subjective International Knee Documentation Committee form. All measures were collected prospectively at a 12-month postoperative clinical review. Patients were evaluated for a minimum 3 years to determine the incidence of subsequent ACL injury. Results: A total of 95 patients (29%) sustained a second ACL injury following clinical assessment and return to sport. There were 50 graft ruptures and 45 contralateral ACL injuries. Patients with a flexion deficit of 5° had over 2 times the odds of sustaining a graft rupture (odds ratio, 2.3; P < .05), and patients with a side-to-side difference in anterior knee laxity of 3 mm or greater had over 2 times the odds of sustaining a contralateral ACL injury (odds ratio, 2.4; P < .05). Overall, 29% (94 of 329) of patients met the threshold for satisfactory function on all 6 clinical measures; these patients had a 33% reduction in the risk of sustaining a second ACL injury ( P = .05) as compared with those who did not meet all clinical thresholds. Conclusion: Clinical measures of knee flexion and stability may have utility to screen for and identify patients who are at greater risk for a second ACL injury in an already high-risk group (ie, age and activity level).

scholarly journals Method for Determining the Isometricity of the Location of the Femoral and Tibial Tunnels Before Their Formation in The Anterior Cruciate Ligament Plasty

2021 ◽  
Vol 9 (4) ◽  
pp. 580-585
Author(s):  
V. V. Slastinin ◽  
N. V. Yarygin ◽  
M. V. Parshikov ◽  
A. M. Fain ◽  
M. V. Sychevsky
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Tibial Tunnel ◽  
Original Method ◽  
Acl Repair ◽  
Key Points ◽  
Anterior Cruciate ◽  
Fixation Points ◽  
Flexion And Extension

Relevance. One of the key points in plasty of the anterior cruciate ligament (ACL) is the isometric position of the graft, in which its tension remains the same during flexion and extension of the knee joint. However, no method has been described today for the intraoperative determination of the isometricity of the location of the femoral and tibial tunnels (for placing the graft) before their formation.Purpose of the study. To develop a method for intraoperative determination of the isometricity of the location of the femoral and tibial tunnels before their formation during ACL plasty and to study its effectiveness.Material and methods. The study included 30 patients who underwent ACL repair. For a preliminary intraoperative assessment of the isometric areas of graft fixation on the femur and tibia, the proposed original method with the use of two knot pushers and a thread passing through them. Isometry was assessed by the degree of displacement of this thread. After determining the isometric areas of fixation, the femoral and tibial tunnels were formed, and the isometric position of the graft before its fixation in the tibia was checked by the degree of displacement of the threads with which the graft was sutured relative to the aperture of the tibial tunnel.Results. The average displacement of the thread relative to the pusher of the knot in the preliminary determination of the isometric areas of fixation according to the proposed method corresponded to the displacement of the threads with which the distal end of the graft was sewn relative to the outer aperture of the tibial tunnel (this value did not exceed 2 mm on average) until the final fixation of the graft in the tibial tunnel.Conclusion. The developed method makes it possible to determine the isometric location of the femoral and tibial tunnels during arthroscopic plasty of the anterior cruciate ligament before their formation. If the location of the fixation points on the femur and tibia is determined non-isometric, it is possible to correct their position.

ACL reconstruction in the professional or elite athlete: state of the art

2021 ◽  
pp. jisakos-2020-000456
Author(s):  
Rafael A Buerba ◽  
Stefano Zaffagnini ◽  
Ryosuke Kuroda ◽  
Volker Musahl
Keyword(s):  
Anterior Cruciate Ligament ◽  
Elite Athlete ◽  
State Of The Art ◽  
Cruciate Ligament ◽  
Return To Sport ◽  
Acl Injury ◽  
Peak Performance ◽  
Acl Injuries ◽  
Anterior Cruciate

Anterior cruciate ligament (ACL) injuries are on the rise at all levels of sport, including elite athletics. ACL injury can have implications on the athlete’s sport longevity, as well as other long-term consequences, such as the development of future knee osteoarthritis. In the elite athlete, ACL injury can also have ramifications in terms of contract/scholastic obligations, sponsorships and revenue-generating potential. Although the goal of anterior cruciate ligament reconstruction (ACLR) is to return any athlete to the same preinjury level of sport, management of ACL injuries in the elite athlete come with the additional challenge of returning him or her to an extremely high level of physical performance. Despite outcome studies after ACLR in elite athletes showing a high return-to-sport rate, these studies also show that very few athletes are able to return to sport at the same level of performance. They also show that those athletes who undergo ACLR have careers that are more short-lived in comparison to those without injury. Thus, returning an elite athlete to ‘near peak’ performance may not be good enough for the athletic demands of elite-level sports. A possible explanation for the variability in outcomes is the great diversity seen in the management of ACL injuries in the elite athlete in terms of rehabilitation, graft choices, portal drilling and reconstruction techniques. Recently, the advent of anatomical, individualised ACLR has shown improved results in ACLR outcomes. However, larger-scale studies with long-term follow-ups are needed to better understand the outcomes of modern ACLR techniques—particularly with the rise of quadriceps tendon as an autograft choice and the addition of lateral extra-articular tenodesis procedures. The purpose of this article was thus to provide an up-to-date state-of-the-art review in the management of ACL injuries in the elite athlete.

scholarly journals Association of Anterior Cruciate Ligament Width With Anterior Knee Laxity

2016 ◽  
Vol 51 (6) ◽  
pp. 460-465 ◽  
Author(s):  
Hsin-Min Wang ◽  
Sandra J. Shultz ◽  
Randy J. Schmitz
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Knee Laxity ◽  
Acl Injury ◽  
Resonance Imaging ◽  
Notch Angle ◽  
Anterior Knee Laxity ◽  
Anterior Cruciate ◽  
Anterior Knee ◽  
Femoral Notch

Context: Greater anterior knee laxity (AKL) has been identified as an anterior cruciate ligament (ACL) injury risk factor. The structural factors that contribute to greater AKL are not fully understood but may include the ACL and bone geometry. Objective: To determine the relationship of ACL width and femoral notch angle to AKL. Design: Cross-sectional study. Setting: Controlled laboratory. Patients or Other Participants: Twenty recreationally active females (age = 21.2 ± 3.1 years, height = 1.66.1 ± 7.3 cm, mass = 66.5 ± 12.0 kg). Main Outcome Measure(s): Anterior cruciate ligament width and femoral notch angle were obtained with magnetic resonance imaging of the knee and AKL was assessed. Anterior cruciate ligament width was measured as the width of a line that transected the ACL and was drawn perpendicular to the Blumensaat line. Femoral notch angle was formed by the intersection of the line parallel to the posterior cortex of the femur and the Blumensaat line. Anterior knee laxity was the anterior displacement of the tibia relative to the femur (mm) at 130 N of an applied force. Ten participants' magnetic resonance imaging data were assessed on 2 occasions to establish intratester reliability and precision. Using stepwise backward linear regression, we examined the extent to which ACL width, femoral notch angle, and weight were associated with AKL. Results: Strong measurement consistency and precision (intraclass correlation coefficient [2,1] ± SEM) were established for ACL width (0.98 ± 0.3 mm) and femoral notch angle (0.97° ± 1.1°). The regression demonstrated that ACL width (5.9 ± 1.4 mm) was negatively associated with AKL (7.2 ± 2.0 mm; R2 = 0.22, P = .04). Femoral notch angle and weight were not retained in the final model. Conclusions: A narrower ACL was associated with greater AKL. This finding may inform the development of ACL injury-prevention programs that include components designed to increase ACL size or strength (or both). Future authors should establish which other factors contribute to greater AKL in order to best inform injury-prevention efforts.

scholarly journals Anterior cruciate ligament – to repair or not to repair?

2020 ◽  
Vol 86 (2) ◽  
pp. 59-65
Author(s):  
Piotr Wodziński ◽  
◽  
Andrzej Wielgus ◽  
Łukasz Mucha ◽  
Tomasz Mazurek ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Sport Activity ◽  
Return To Sport ◽  
Acl Injury ◽  
Actual State ◽  
Type I ◽  
Acl Repair ◽  
Internal Bracing ◽  
Anterior Cruciate

Anterior cruciate ligament injuries are one of the most frequent knee joint injuries, leading to instability which limits return to sport activity, and is one of osteoarthritis risk factors. Treatment issues are present since 1895, when Mayo Robertson performed first documented open ACL repair. Positive short-term results of open suturing led to rising popularity of this method, which in 70’s and 80’s became golden standard of ACL injury treatment. Feagin in his longterm observations noticed that nearly half of patients after open ACL repair, during first 5 years suffered from reappearing ACL tear. Since then, for many years reconstruction techniques with graft use became most popular technique. Increasing knowledge of ligament healing biology, creation of Sherman’s ACL injury location classification, development of arthroscopic techniques, connected with growing tendency for biological treatment caused increase in repair techniques interest. Most important potential benefits of this techniques are: limitation of perioperative trauma – no need to harvest graft, drill large tunnels, possible retention of additional ACL proprioceptive feeling, easier eventual reoperation. Effort to save patient’s ACL is especially indicated in case of acute trauma (depending on source up to 3-14 weeks from injury), with proximal tear (type I in Sherman classification) with good remnant quality. Most popular techniques of ACL repair are: proximal ACL attachment reinsertion, IBLA – Internal Bracing Ligament Augmentation and DIS – Dynamic Intraligamentary Stabilization. The aim of this study was to present actual state of knowledge concerning options of primary ACL repair, it’s results, indications, and sharing authors own experiences in this treatment methods. Preliminary, available in literature, results of studies concerning methods mentioned above are good and very good, comparable, and sometimes even superior to results of classical ACL reconstruction. However, there is lack of long-term studies, that might confirm increase in survivorship rate of repaired ACLs comparing to previous open suturing technique.

scholarly journals EVALUATION OF SERUM RELAXIN CONCENTRATIONS AND KNEE VALGUS AFTER ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION

2020 ◽  
Vol 8 (4_suppl3) ◽  
pp. 2325967120S0013
Author(s):  
Gabrielle G. Gilmer ◽  
Michael D. Roberts ◽  
Gretchen Oliver
Keyword(s):  
Anterior Cruciate Ligament ◽  
Health Outcomes ◽  
Luteal Phase ◽  
Female Athletes ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Knee Valgus ◽  
Increased Risk ◽  
Anterior Cruciate

Background: Athletes who sustain an anterior cruciate ligament (ACL) injury are more likely to develop adverse health outcomes, such as knee osteoarthritis, knee pain, and obesity. It is assumed that the long-term consequences of ACL reconstruction are caused by the reconstruction itself. Studies have observed that relaxin, a peptide hormone similar in structure to insulin, interferes with the structural integrity of the ACL and elicits long term effects on bone, joint, muscle, and tendon health. Given the known effects of relaxin, it is reasonable to wonder if relaxin contributes to the development of these long-term health outcomes, independently of the ACL injury. Hypothesis/Purpose: The purpose of this study was to evaluate knee valgus and serum relaxin concentrations (SRC) in athletes who have and have not sustained an ACL injury. It was hypothesized that athletes who previously tore their ACL would have higher SRC and more knee valgus than those who were injury free. Methods: Twenty-two female athletes participated. Participants were assigned to one of two groups: ACL injury (6.0 ± 3.3 years after surgery, N = 4) and injury free (N = 18). Kinematic data were collected at 100 Hz using The MotionMonitor. Participants performed a single leg squat (SLS), single leg crossover dropdown (SCD), and drop vertical jump (DVJ) at two different time points in their menstrual period: pre-ovulatory phase and mid-luteal phase. Blood samples were collected when SRC are measurable (mid-luteal phase), and SRC were determined using a Quantikine Human Relaxin-2 Immunoassay. Results: Independent samples t-tests revealed significant differences between those who tore their ACL and those who were injury free in SRC and knee valgus during the SLS in the mid luteal phase, DVJ in both phases, and SCD in both phases. Specifically, the participants who tore their ACL had significantly higher SRC and more knee valgus than those who did not tear their ACL. Conclusion: These findings suggest that a previous ACL injury could place one at an increased risk of re-tear and other adverse effects on their joints, muscles, and tendons. Thus, further investigating hormonal risk factors during long term monitoring of recovery is needed.

scholarly journals Good to Excellent Functional Short-Term Outcome and Low Revision Rates Following Primary Anterior Cruciate Ligament Repair Using Suture Augmentation

2020 ◽  
Vol 9 (10) ◽  
pp. 3068
Author(s):  
Kristian Nikolaus Schneider ◽  
Benedikt Schliemann ◽  
Georg Gosheger ◽  
Christoph Theil ◽  
Jan Weller ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Revision Surgery ◽  
Cruciate Ligament ◽  
Knee Laxity ◽  
Functional Results ◽  
Acl Repair ◽  
Term Outcome ◽  
Ikdc Score ◽  
Anterior Cruciate

The aim of this study was to evaluate the functional outcome of primary anterior cruciate ligament (ACL) repair using suture augmentation (SA) in 93 consecutive patients (67 female) with a minimum follow-up of 12 months. Patients’ outcomes were determined using International Knee Documentation Committee (IKDC) score, Lysholm score (LS) and Tegner score (TS). Knee-laxity was assessed using the KT-1000 arthrometer. Eighty-eight patients (67 female, mean age 42 years ± standard deviation (SD) 13) were available for follow-up after a mean time of 21 months (range 12–39). Three patients (3%) underwent revision surgery and were excluded from functional analysis. The mean IKDC score was 87.4 ± 11, mean LS was 92.6 ± 11, mean pre-traumatic TS was 6 ± 2 and mean postoperative TS was 6 ± 2, with a mean difference (TSDiff) of 1 ± 1. The interval from injury to surgery had no significant impact on the postoperative IKDC (p = 0.228), LS (p = 0.377) and TSDiff (p = 0.572). Patients’ age (>40 years), BMI (>30) and coexisting ligament or meniscal injuries did not seem to influence postoperative functional results. Primary ACL repair using SA provides good to excellent functional outcomes with a low probability of revision surgery at a minimum of 12 months.

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