Anterior cruciate ligament repair with internal brace augmentation: a systematic review

W.T. Wilson, G.P. Hopper, M.S. Banger, M.J.G. Blyth, P.E. Riches, G.M. Mackay

Research output: Contribution to journalReview articlepeer-review

25 Citations (Scopus)
358 Downloads (Pure)

Abstract

Background
Primary repair of anterior cruciate ligament (ACL) ruptures has re-emerged as a treatment option for proximal tears, with internal brace augmentation often utilised. The aim of this study is to provide an overview of the current evidence presenting outcomes of ACL repair with internal bracing to assess the safety and efficacy of this technique.

Methods
All studies reporting outcomes of arthroscopic primary repair of proximal ACL tears, augmented with internal bracing from 2014-2021 were included. Primary outcome was failure rate and secondary outcomes were subjective patient reported outcome measures (PROMs) and objective assessment of anteroposterior knee laxity.

Results
Nine studies were included, consisting of 347 patients, mean age 32.5 years, mean minimum follow up 2 years. There were 36 failures (10.4%, CI 7.4% - 14.1%). PROMs reporting was variable across studies. KOOS, Lysholm and IKDC scores were most frequently used with mean scores > 87%. The mean Tegner and Marx scores at follow-up were 6.1 and 7.8 respectively. The mean side to side difference measured for anteroposterior knee laxity was 1.2mm.

Conclusions
This systematic review with meta-analysis shows that ACL repair with internal bracing is a safe technique for treatment of proximal ruptures, with a failure rate of 10.4%. Subjective scores and clinical laxity testing also revealed satisfactory results. This suggests that ACL repair with internal bracing should be considered as an alternative to ACL reconstruction for acute proximal tears, with the potential benefits of retained native tissue and proprioception, as well as negating the need for graft harvest.
Original languageEnglish
Pages (from-to)192-200
Number of pages9
JournalThe Knee
Volume35
Early online date30 Mar 2022
DOIs
Publication statusPublished - 30 Mar 2022

Keywords

  • ACL
  • anterior cruciate ligament (ACL)
  • internal brace augmentation
  • ACL repair

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