Gordon MacKay, Iain C Anthony, Paul J Jenkins and Mark Blyth*
Background: There is renewed interest in ACL repair following rupture with the development of new repair techniques. The aim of the audit was to assess outcomes and complications of ACL repair with Internal Brace Ligament Augmentation (IBLA) at minimum one year follow-up.
Materials and methods: 68 consecutive patients who underwent Anterior Cruciate Ligament (ACL) repair with IBLA were followed for a minimum of one year following surgery. Knee Injury and Osteoarthritis Outcome Score (KOOS) and Western Ontario and McMaster osteoarthritis index (WOMAC) scores were collected at set time points via an online outcomes system. Improvements in scores from baseline were recorded and effect sizes for the five KOOS and three WOMAC domains were calculated. Patients suffering from re-rupture or undergoing re-interventions were identified and Kaplan-Meier survivorship calculated.
Results: Improvement was seen over the study period in all KOOS and WOMAC domains with the majority of improvement seen in the first three months. The results were comparable to the literature on ACL reconstruction. In the KOOS score, the greatest effect size at one year was seen in the Quality of Life (QoL) (2.82, 95% CI 2.25 to 3.39) and Sport domains (2.60, 95% CI 2.09 to 2.12). The lowest KOOS effect size was seen in the Activities of Daily Living (ADL) domain (1.1, 95% CI 0.68 to 1.51), with similar smaller improvements seen in the WOMAC domains.
There were four re-interventions including one for re-rupture, and one each for surgery for arthrofibrosis, meniscal tear and chondral parthology.
Conclusions: This audit provides early functional outcome and failure data that demonstrates the technique of ACL repair with IBLA is comparable with early results from ACL reconstruction, with the greatest improvements seen in return to sporting activity. Further randomised studies are required to directly compare repair against standard ACL reconstruction techniques.