Suture Augmented Versus Standard Anterior Cruciate Ligament Reconstruction: A Matched Comparative Analysis.

MedStar author(s):
Citation: Arthroscopy. 35(7):2114-2122, 2019 07.PMID: 31167738Institution: MedStar Washington Hospital CenterDepartment: MedStar Georgetown Orthopedic Institute, Washington Hospital Center | Orthopedic SurgeryForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Anterior Cruciate Ligament Reconstruction/mt [Methods] | *Hamstring Tendons/tr [Transplantation] | *Sutures | Adolescent | Adult | Allografts | Arthralgia/pp [Physiopathology] | Autografts | Female | Follow-Up Studies | Humans | Knee Joint/pp [Physiopathology] | Male | Matched-Pair Analysis | Middle Aged | Pain Measurement | Patient Reported Outcome Measures | Range of Motion, Articular/ph [Physiology] | Retrospective Studies | Young AdultYear: 2019Local holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library:2004 - 2007ISSN:
  • 0749-8063
Name of journal: Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy AssociationAbstract: CONCLUSIONS: Our study demonstrates that SA hamstring ACLRs were associated with improved PROMs, less pain, and a higher percentage of and earlier return to preinjury activity level when compared with standard hamstring ACLRs without evidence of overconstraint.Copyright (c) 2019 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.LEVEL OF EVIDENCE: Level III, retrospective comparative study.METHODS: Patients who underwent ACLR with hamstring autografts or allografts with minimum 2-year follow-up were retrospectively reviewed. Patients undergoing ACLR with SA were matched 1:1 by age, gender, body mass index, graft type, and revision status to standard ACLR. Range of motion, pain, postoperative activity, patient-reported outcome measures (PROMs), and complications were collected. Paired 2-tailed Student's t-tests and Pearson's chi<sup>2</sup>-tests were used for continuous and categorical variables, respectively. A multivariate analysis of variance was conducted. Return to preinjury activity level was assessed using Spearman's rho and Pearson's chi<sup>2</sup>-tests.PURPOSE: To compare outcomes between standard anterior cruciate ligament reconstruction (ACLR) using hamstring grafts with and without suture augmentation (SA).RESULTS: Sixty patients at a mean age of 29.50 +/- 6.60 years, 43.4% male, body mass index 26.27 +/- 3.37, and follow-up of 29.54 +/- 5.37 months were included. Preoperative PROMs were not significantly different (P >. 05). Postoperative range of motion was similar between groups (P = .457). Postoperative average daily (0.60 +/- 1.25 vs 1.66 +/- 1.90) and maximum daily pain (1.57 +/- 1.83 vs 3.35 +/- 2.28) were significantly lower for SA (P < .014). SA predicted improvement in PROMs (P < .05) and maximum pain scores (P = .001). SA was significantly correlated with improved time to return to preinjury activity level (9.17 +/- 2.06 vs 12.88 +/- 3.94 months; P = .002) and percentage of preinjury activity level (93.33% +/- 13.22% vs 83.17% +/- 17.69%; P = .010). There was a trend toward improved rate of return to preinjury activity level for SA (76.7% vs 56.7%; P = .100).All authors: Apseloff NA, Argintar EH, Bodendorfer BM, Michaelson EM, Nolton EC, Shu HT, Spratt JDOriginally published: Arthroscopy. 35(7):2114-2122, 2019 Jul.Fiscal year: FY2020Digital Object Identifier: Date added to catalog: 2019-06-21
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Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 31167738 Available 31167738

Available online from MWHC library: 1995 - present, Available in print through MWHC library:2004 - 2007

CONCLUSIONS: Our study demonstrates that SA hamstring ACLRs were associated with improved PROMs, less pain, and a higher percentage of and earlier return to preinjury activity level when compared with standard hamstring ACLRs without evidence of overconstraint.

Copyright (c) 2019 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

LEVEL OF EVIDENCE: Level III, retrospective comparative study.

METHODS: Patients who underwent ACLR with hamstring autografts or allografts with minimum 2-year follow-up were retrospectively reviewed. Patients undergoing ACLR with SA were matched 1:1 by age, gender, body mass index, graft type, and revision status to standard ACLR. Range of motion, pain, postoperative activity, patient-reported outcome measures (PROMs), and complications were collected. Paired 2-tailed Student's t-tests and Pearson's chi<sup>2</sup>-tests were used for continuous and categorical variables, respectively. A multivariate analysis of variance was conducted. Return to preinjury activity level was assessed using Spearman's rho and Pearson's chi<sup>2</sup>-tests.

PURPOSE: To compare outcomes between standard anterior cruciate ligament reconstruction (ACLR) using hamstring grafts with and without suture augmentation (SA).

RESULTS: Sixty patients at a mean age of 29.50 +/- 6.60 years, 43.4% male, body mass index 26.27 +/- 3.37, and follow-up of 29.54 +/- 5.37 months were included. Preoperative PROMs were not significantly different (P >. 05). Postoperative range of motion was similar between groups (P = .457). Postoperative average daily (0.60 +/- 1.25 vs 1.66 +/- 1.90) and maximum daily pain (1.57 +/- 1.83 vs 3.35 +/- 2.28) were significantly lower for SA (P < .014). SA predicted improvement in PROMs (P < .05) and maximum pain scores (P = .001). SA was significantly correlated with improved time to return to preinjury activity level (9.17 +/- 2.06 vs 12.88 +/- 3.94 months; P = .002) and percentage of preinjury activity level (93.33% +/- 13.22% vs 83.17% +/- 17.69%; P = .010). There was a trend toward improved rate of return to preinjury activity level for SA (76.7% vs 56.7%; P = .100).

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