Less Subsequent Revision Anterior Cruciate Ligament Reconstruction following Primary Bone-Patellar Tendon-Bone ACL Reconstruction with Suture Tape Augmentation – A Retrospective Comparative Therapeutic Trial with 5-year Follow-up

ABSTRACT

Purpose

To investigate patient outcomes, including revision rate, following primary bone patellar-tendon bone autograft (BTB) anterior cruciate ligament reconstruction (ACLR) with and without suture tape augmentation (STA) in a young and active cohort.

Methods

All eligible patients who received primary BTB ACLR with a minimum of 2-year follow-up were included in this retrospective cohort study. All patients receiving STA were augmented with the same device. Patients completed the following patient-reported outcome measures (PROMs): the Visual Analog Scale, the Single Assessment Numeric Evaluation, the Knee Injury and Osteoarthritis Outcome Score subscales, and the Tegner activity scale. Anteroposterior knee laxity was assessed using a KT-1000 arthrometer preoperatively and 1-year postoperatively. Posterior tibial slope (PTS), femoral tunnel angle (FTA), and tibial tunnel placement were calculated for all patients. Subsequent surgical interventions and return to sport (RTS) was obtained from each patient.

Results

One hundred and fifteen patients (52 BTB ACLR with STA, 62 traditional BTB ACLR) with a mean patient age < 19-years-old and a mean final follow-up of ≥ 5 years were included. Compared to the control group, the STA group demonstrated significantly less subsequent revision ACLR (0 vs. 5, p=0.036). All PROMs and KT-1000 measurements improved at final follow-up (p < 0.001) and were comparable between groups. There were no differences seen in either PTS or graft tunnel placement between groups. Over 85% of the patients were able to return to the sport that led to their injury at full capacity with no differences seen in RTS rate, time to RTS, or level of competition between groups.

Conclusion

Compared to traditional BTB ACLR, additional STA appeared to safely and effectively lead to less subsequent revision ACLR while maintaining acceptable PROMs and objective joint laxity measurements in a young and active patient population.

Level of evidence

III..