Magnetic Resonance Imaging and Functional Performance Outcome After ACL Repair With Internal Brace Technique
Condition: Anterior Cruciate Ligament Tear
MeSH terms: Anterior Cruciate Ligament Injuries
Study type: Observational

Summary: 
      The purpose of the study is a clinical evaluation with special regard to magnetic resonance
      imaging and functional performance at least one year after injury / surgery in all three
      groups (subjects who underwent InternalBrace surgery, subjects who underwent surgery with a
      semitendinosus graft and subjects who were treated conservatively).
    

Detailed description: 
      Lesions of the anterior cruciate ligament (ACL) are the most common ligamentous injuries with
      an increasing incidence. 77% of ACL insufficient knees result in moderate to high physical
      limitations. Different surgical treatments have been described. ACL reconstruction with
      either a semitendinosus or patella tendon graft is regarded as the gold standard of operative
      therapy. Despite numerous studies representing good and excellent outcome after ACL
      reconstruction, a recent Meta-analysis of Biau et al. 2006 revealed that only 40% of patients
      gain full functional recovery.

      Since the native ACL is considered to be an important factor for the proprioceptive
      sensation, a removal during the reconstruction might have an adverse influence on muscular
      stabilisation, rehabilitation and functional performance of the knee joint. Thus a primary
      repair of the native ACL seems reasonable.

      For tears of the anterior cruciate ligament near the femoral attachment a new method of
      surgical treatment can be applied. The InternalBrace method by Arthrex is performed
      arthroscopically and involves reattaching of the ACL that has avulsed off the femoral wall
      using a FiberTape by Arthrex. To the authors knowledge the augmentation with FiberTape by
      Arthrex has not been systematically evaluated. Promising results have been presented recently
      using a comparable method, which showed a high patient satisfaction, faster rehabilitation
      and a high rate of return to pre-injury sports level.

      To assess the functional performance, a further aim of the study is to develop a new test
      battery consisting of strength tests and single-leg hop tests with the ability to distinguish
      between the functional performance of the injured and the uninjured leg in patients with ACL
      deficiency. Test batteries consisting of several hop tests has been described in the previous
      literature indicating a good test-retest reliability measuring lower leg performance. The
      functional performance is defined using the limb symmetry index in percent between each
      individuals lower limbs. This study aims to determine the LSI of healthy subjects using the
      values achieved by the subjects in the control group. A limb symmetry index (LSI) between 85%
      and 95% is considered sufficient for return to pivoting sports in patients after knee injury.
    

Observational model: Cohort
Time perspective: Retrospective
Sampling method: Non-Probability Sample
Study population: 
        Patients with rupture of the ACL between 18 and 60 years
      
Keywords: ACL tear; ACL lesion; ACL reconstruction; InternalBrace; functional performance test; anterior cruciate ligament