Anatomic ACL repair with suture tape augmentation and cortical button fixation for acute proximal anterior cruciate ligament tears: results in short-term outcomes similar to those of ACL reconstruction with hamstring autograft

Purpose The treatment of choice for anterior cruciate ligament (ACL) ruptures remains the use of tendon grafts. However, the concept of preserving the ACL instead of replacing it has gained popularity for the treatment of acute femoral avulsion tears. This study aimed to evaluate the effectiveness of ligament-preserving repair technique, for clarity hereafter referred to as the Ligabrace technique, involving suture tape augmentation and cortical button fixation. Methods The study included 50 patients with isolated acute proximal ACL rupture (Sherman I / II) who did not have any other injuries or medical conditions. The patients were divided into two groups: group 1 (n = 25) underwent surgical treatment with the Ligabrace technique, while group 2 (n = 25) received standard ACL reconstruction with hamstring tendons. Preoperative assessments of Tegner, Lysholm, and International Knee Documentation Committee (IKDC) scores were conducted at T0, and 12 months postoperatively at T2. Additionally, standardized Magnetic resonance imaging (MRI) and routine clinical examinations of the knee, including instrumented anterior-posterior (AP) stability measurements, were carried out at T1 and T2. Results No significant differences in any of the evaluation criteria were observed in either group at T2. The Lysholm (90,32 (71–100)) and IKDC (87,1 (62,1-100)) scores were comparable for the Ligabrace group and the scores for the hamstring group. The Tegner activity levels were 6.2 ± 1.7 in the Ligabrace group and 5.8 ± 1.7 in the hamstring group. The mean AP translation compared to the noninjured knee was 0.56 mm in the Ligabrace group and 0.72 mm in the hamstring group. Conclusion Overall, primary ACL repair with this technique showed similar outcomes to ACL reconstruction with hamstring tendons in terms of patient-reported outcome scores and clinical investigation in patients with proximal ACL tears in short-term. The initial results for the Ligabrace technique suggest that it may be a viable option for ligament preservation after acute femoral ACL tears.