Suture tape reinforcement of hamstring tendon graft reduces postoperative knee laxity after primary ACL reconstruction

Abstract Purpose To evaluate and compare subjective and objective knee outcomes following hamstring tendon (HT) and quadriceps tendon (QT) anterior cruciate ligament reconstruction (ACLR) with or without suture tape (ST) reinforcement. It was hypothesized that the addition of an intra‐articular synt...

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Main Authors: Christoffer vonEssen, Vasileios Sarakatsianos, Riccardo Cristiani, Anders Stålman
Format: Article
Language:English
Published: Wiley 2022-01-01
Series:Journal of Experimental Orthopaedics
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Online Access:https://doi.org/10.1186/s40634-022-00454-2
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author Christoffer vonEssen
Vasileios Sarakatsianos
Riccardo Cristiani
Anders Stålman
author_facet Christoffer vonEssen
Vasileios Sarakatsianos
Riccardo Cristiani
Anders Stålman
author_sort Christoffer vonEssen
collection DOAJ
description Abstract Purpose To evaluate and compare subjective and objective knee outcomes following hamstring tendon (HT) and quadriceps tendon (QT) anterior cruciate ligament reconstruction (ACLR) with or without suture tape (ST) reinforcement. It was hypothesized that the addition of an intra‐articular synthetic augmentation with a ST would reduce postoperative knee laxity and graft ruptures after ACLR. Methods A 1:1 matched‐cohort comparison of patients who underwent HT and QT autograft ACLR with or without ST reinforcement was performed. Patients with ST reinforcement were consecutively assigned to the study groups until a number of 20 in each group was achieved. Medical records were reviewed for demographic characteristics and additional injuries. Laxity measurements with KT‐1000, strength measurements and physical examination findings were collected both preoperatively and at 6 months and patient reported outcome (PRO) scores were collected both preoperatively and at 12 months, and comparison was made HT vs HT + ST and QT vs QT + ST. Reoperations and re‐ruptures were recorded during the 24‐month follow‐up period. Results Overall, 80 patients who underwent ACLR were included. Patients with HT + ST had significant less laxity postoperatively compared to HT at 6 months, 1.9 vs 0.8 mm, p < 0.05. No differences were found between the QT and QT + ST group. At 6 weeks patients treated with ST, both QT and HT, had a significant deficit in flexion compared to those without ST. However, this resolved at 6 months. There were no significant differences between HT + ST vs HT, or QT + ST vs QT, regarding postoperative PROs or strength measurements. Furthermore, the incidence of subsequent surgery and graft rupture was not significantly different between the groups. Conclusion ACLR with HT + ST reduces laxity at 6 months compared to ACLR without ST, a difference not seen when ACLR was performed using QT with or without ST. No other differences were seen between the two techniques comparing subjective and objective findings. Level of evidence Level III.
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spelling doaj-art-7b5986361f2b4a5f9b672834717a6bf92025-08-20T02:05:21ZengWileyJournal of Experimental Orthopaedics2197-11532022-01-0191n/an/a10.1186/s40634-022-00454-2Suture tape reinforcement of hamstring tendon graft reduces postoperative knee laxity after primary ACL reconstructionChristoffer vonEssen0Vasileios Sarakatsianos1Riccardo Cristiani2Anders Stålman3Department of Molecular Medicine and SurgeryStockholm Sports Trauma Research CenterKarolinska InstitutetStockholmSwedenDepartment of Molecular Medicine and SurgeryStockholm Sports Trauma Research CenterKarolinska InstitutetStockholmSwedenDepartment of Molecular Medicine and SurgeryStockholm Sports Trauma Research CenterKarolinska InstitutetStockholmSwedenDepartment of Molecular Medicine and SurgeryStockholm Sports Trauma Research CenterKarolinska InstitutetStockholmSwedenAbstract Purpose To evaluate and compare subjective and objective knee outcomes following hamstring tendon (HT) and quadriceps tendon (QT) anterior cruciate ligament reconstruction (ACLR) with or without suture tape (ST) reinforcement. It was hypothesized that the addition of an intra‐articular synthetic augmentation with a ST would reduce postoperative knee laxity and graft ruptures after ACLR. Methods A 1:1 matched‐cohort comparison of patients who underwent HT and QT autograft ACLR with or without ST reinforcement was performed. Patients with ST reinforcement were consecutively assigned to the study groups until a number of 20 in each group was achieved. Medical records were reviewed for demographic characteristics and additional injuries. Laxity measurements with KT‐1000, strength measurements and physical examination findings were collected both preoperatively and at 6 months and patient reported outcome (PRO) scores were collected both preoperatively and at 12 months, and comparison was made HT vs HT + ST and QT vs QT + ST. Reoperations and re‐ruptures were recorded during the 24‐month follow‐up period. Results Overall, 80 patients who underwent ACLR were included. Patients with HT + ST had significant less laxity postoperatively compared to HT at 6 months, 1.9 vs 0.8 mm, p < 0.05. No differences were found between the QT and QT + ST group. At 6 weeks patients treated with ST, both QT and HT, had a significant deficit in flexion compared to those without ST. However, this resolved at 6 months. There were no significant differences between HT + ST vs HT, or QT + ST vs QT, regarding postoperative PROs or strength measurements. Furthermore, the incidence of subsequent surgery and graft rupture was not significantly different between the groups. Conclusion ACLR with HT + ST reduces laxity at 6 months compared to ACLR without ST, a difference not seen when ACLR was performed using QT with or without ST. No other differences were seen between the two techniques comparing subjective and objective findings. Level of evidence Level III.https://doi.org/10.1186/s40634-022-00454-2ACLACL reconstructionsuture tape reinforcement
spellingShingle Christoffer vonEssen
Vasileios Sarakatsianos
Riccardo Cristiani
Anders Stålman
Suture tape reinforcement of hamstring tendon graft reduces postoperative knee laxity after primary ACL reconstruction
Journal of Experimental Orthopaedics
ACL
ACL reconstruction
suture tape reinforcement
title Suture tape reinforcement of hamstring tendon graft reduces postoperative knee laxity after primary ACL reconstruction
title_full Suture tape reinforcement of hamstring tendon graft reduces postoperative knee laxity after primary ACL reconstruction
title_fullStr Suture tape reinforcement of hamstring tendon graft reduces postoperative knee laxity after primary ACL reconstruction
title_full_unstemmed Suture tape reinforcement of hamstring tendon graft reduces postoperative knee laxity after primary ACL reconstruction
title_short Suture tape reinforcement of hamstring tendon graft reduces postoperative knee laxity after primary ACL reconstruction
title_sort suture tape reinforcement of hamstring tendon graft reduces postoperative knee laxity after primary acl reconstruction
topic ACL
ACL reconstruction
suture tape reinforcement
url https://doi.org/10.1186/s40634-022-00454-2
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AT vasileiossarakatsianos suturetapereinforcementofhamstringtendongraftreducespostoperativekneelaxityafterprimaryaclreconstruction
AT riccardocristiani suturetapereinforcementofhamstringtendongraftreducespostoperativekneelaxityafterprimaryaclreconstruction
AT andersstalman suturetapereinforcementofhamstringtendongraftreducespostoperativekneelaxityafterprimaryaclreconstruction