NEW ORLEANS — Primary arthroscopic repair of proximal avulsion-type ACL tears was associated with good midterm results, according to data presented at the American Academy of Orthopaedic Surgeons Annual Meeting.
“When looking at the 2-year and 5-year results, which historically decrease, no deterioration was found, and three patients had a postoperative MRI and were found to have a continuous ligament,” Jelle P. van der List, MD, said in his presentation. “So historically, the outcomes of open primary repair deteriorated from short to midterm follow-up. In our cohort, however, this deterioration was not seen. This could be explained by a couple of factors. First of all, strict patient selection was applied. Only patients with proximal avulsion-type tears were included. Secondly, we did arthroscopic surgery and historically it was arthrotomy.”
Jelle P. van der List
van der List and colleagues studied the first 11 patients who had proximal ACL tears that were treated arthroscopically.
The repair technique used involved independent suturing of the anteromedial and posterolateral bundles from distal to proximal. This was done in an alternating pattern at two different levels and both levels were fixed to the anatomical ACL footprint with suture anchors, van der List said.
Ten of the 11 patients returned to the clinic at 5 years postoperatively for evaluation. All seen patients had full range of motion, according to the results.
In terms of outcomes for these 10 patients, van der List said nine patients had a subjective IKDC score of 92.3. The mean Lysholm score was 96 and the mean modified Cincinnati score was 95.6. The postoperative Tegner score was 6.6. – by Susan M. Rapp
van der List JP, et al. Paper #394. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 6-10, 2018; New Orleans.
Disclosure: van der List reports no relevant financial disclosures.