Clinical Outcomes of Arthroscopic Primary Repair of Proximal Anterior Cruciate Ligament Tears Are Maintained at Mid-term Follow-up

Abstract

To assess the mid-term clinical outcomes in patients with proximal avulsion anterior cruciate ligament (ACL) tears undergoing arthroscopic primary repair with suture anchors. The first 11 consecutive patients with proximal avulsion tears treated with arthroscopic primary repair were evaluated at mid-term (minimum 5-year) follow-up. Physical examination was performed; laxity examination consisting of the Lachman, pivot-shift, and anterior drawer tests was performed; and patients were asked to complete the Lysholm, modified Cincinnati, Single Assessment Numeric Evaluation, and International Knee Documentation Committee (IKDC) questionnaires. Of the 11 patients, 10 were seen at a mean follow-up of 6.0 ± 1.5years (range, 4.8-9.2years). One patient was lost to follow-up, in whom failure had already occurred at short-term follow-up. One additional patient underwent reoperation for a medial meniscus tear and also had a partial ACL tear; this patient was clinically stable at last follow-up. All patients had full range of motion. Nine patients had negative Lachman and negative pivot-shift examination findings (IKDC score of A), and 1 patient had a 1A Lachman result and 1+ pivot-shift result (IKDC score of B). The mean Lysholm score was 96.0 ± 4.5 (range, 88-100); modified Cincinnati score, 95.6 ± 7.4 (range, 80-100); Single Assessment Numeric Evaluation score, 95.4 ± 5.4 (range, 85-100); preinjury Tegner score, 7.2 ± 1.2 (range, 5-9); postoperative Tegner score, 6.6 ± 1.8 (range, 3-9); and IKDC subjective score, 92.3 ± 11.3 (range, 64-100). The clinical outcomes of arthroscopic primary repair of proximal ACL tears with suture anchors are excellent and are maintained at mid-term follow-up in a carefully selected subset of patients with proximal tears and excellent tissue quality. Level IV, therapeutic case series.