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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 1/2019

01-01-2019 | KNEE

Dynamic intraligamentary stabilization for ACL repair: a systematic review

Authors: Sufian S. Ahmad, Anna J. Schreiner, Michael T. Hirschmann, Steffen Schröter, Stefan Döbele, Marc D. Ahrend, Ulrich Stöckle, Atesch Ateschrang

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 1/2019

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Abstract

Purpose

It was the aim to assess all published original research dealing with dynamic repair of the anterior cruciate ligament (ACL) and to provide a semi-quantitative analysis of clinical outcome reports.

Methods

Both OVIS and MEDLINE databases were utilized for allocation of articles. All preclinical and clinical studies related to dynamic intraligamentary stabilization (DIS) were identified. Results were tabulated and semi-quantitative analysis performed.

Results

Twenty-three articles related to DIS were identified. The predominant level of evidence ranged between II and IV, with only one level I study. Reported failure rates ranged between 4% and 13.6%. Most clinical studies only reported revision rates without referring to failure of restoring stability. Highest success was achieved with proximal ACL ruptures. Both the level of physical activity and  patient age have been found to influence the risk of failure.

Conclusion

There is sufficient evidence to support that DIS repair may be an effective modality for the treatment of acute proximal tears of the ACL. However, comparative studies are lacking. Upcoming studies should compare the technique to ACL reconstruction with failure as an endpoint. Comparison to rigid methods of proximal fixation is also necessary to justify the need for dynamic fixation. Overall, there is evidence to suggest the potential space for ACL repair in the decision tree for individualized treatment planning. The best outcome will be in the hands of the best patient selectors.

Level of evidence

IV.
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Metadata
Title
Dynamic intraligamentary stabilization for ACL repair: a systematic review
Authors
Sufian S. Ahmad
Anna J. Schreiner
Michael T. Hirschmann
Steffen Schröter
Stefan Döbele
Marc D. Ahrend
Ulrich Stöckle
Atesch Ateschrang
Publication date
01-01-2019
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 1/2019
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-018-5301-z

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