No Difference in Clinical Outcomes Between Concomitant Anterior and Posterior Cruciate Ligament Reconstruction With and Without Independent Suture Tape Augmentation

同时进行前交叉韧带和后交叉韧带重建,无论是否采用独立缝合带加固,临床结果均无差异

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Abstract

PURPOSE: To compare clinical and functional outcomes (including range of motion, clinical laxity, reoperation/revision rates, and patient-reported outcome measures) of combined anterior cruciate ligament/posterior cruciate ligament reconstruction (ACLR/PCLR) with and without suture tape (ST) augmentation via a propensity-matched cohort analysis. METHODS: A retrospective review was performed to identify all patients who underwent simultaneous primary ACLR/PCLR between 2001 and 2022. A 1:1 propensity match was performed using patient sex, Schenck classification grade, age ±8 years, and body mass index ±10 to produce 2 cohorts: ACLR/PCLR with and without (control) ST augmentation. Clinical outcomes (visual analog scale [VAS], range of motion, Tegner activity scale, Lysholm score, and International Knee Documentation Committee subjective score) were analyzed. RESULTS: The propensity match produced a final cohort of 50 ACLR/PCLR patients: 25 with ST augmentation and 25 nonaugmented controls. Most patients had a KD3M injury (12 in each cohort), and no significant differences were noted in concomitant neurovascular, meniscal, or chondral injuries between the groups. Forty patients (80%) completed follow-up at a mean of 4.7 years for the ST cohort and 8.5 years for the control cohort (P > .05). Postoperative ST versus control values for outcome measures including VAS at rest (0.9 vs 1.5; P = .71), VAS with use (3.0 vs 2.2; P = .24), International Knee Documentation Committee (75.7 vs 76.3; P = .37), Lysholm (81.8 vs 77.6; P = .91), and Tegner activity (4.8 vs 5.4; P = .37) scores showed no differences (P > .05 for all). There were no differences in excessive postoperative clinical laxity between ST and control cohorts (ST n = 1 vs control n = 2, Lachman 2+, P = .140; ST n = 3 vs control n = 1, posterior drawer 2+, P = .122). The total number of patients who underwent reoperation was 7 of 25 (28%) for the ST cohort and 8 of 25 (32%) for the control cohort (P = .76). CONCLUSIONS: Concomitant ACLR/PCLR utilizing ST augmentation showed similarly satisfactory postoperative clinical outcomes at a minimum 2-year follow-up compared to a matched cohort without ST. The use of an independent ST did not limit motion or increase the incidence of complications or revision surgery. LEVEL OF EVIDENCE: Level III, retrospective comparative case series.

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