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Review
, 4 (1), 37

A Narrative Review of Four Different New Techniques in Primary Anterior Cruciate Ligament Repair: "Back to the Future" or Another Trend?

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Review

A Narrative Review of Four Different New Techniques in Primary Anterior Cruciate Ligament Repair: "Back to the Future" or Another Trend?

Michael-Alexander Malahias et al. Sports Med Open.

Abstract

Recently, four different operative techniques, referring to the primary anterior cruciate ligament (ACL) repair, were described. These are the dynamic intraligamentary stabilization (DIS) with Ligamys™, the Bridge-enhanced repair (BEAR), the use of internal brace, and the refixation with suture anchors. The purpose of this study was to assess the already-published, clinical, and pre-clinical results of those techniques. A literature review was conducted and implemented by three independent researchers. Inclusion criteria were clinical or cadaveric or animal studies about patients suffering from ACL rupture, who were treated with one of those four different arthroscopic techniques of primary ACL repair. There were 10 clinical trials dealing with the different techniques of primary ACL repair and 12 cadaveric or animal studies. The majority of the published clinical trials investigated the dynamic intraligamentary stabilization (DIS), while only four studies referred to the three other surgical techniques. Most of the clinical trials suggested that primary ACL repair should be done during the first 14-21 days after a proximal ACL rupture and not later. Further clinical evidence is needed for the techniques of bridge-enhanced ACL repair, internal brace, and suture anchors ACL refixation in order to support the animal and cadaveric biomechanical studies. Till now, the existing clinical trials were not enough to establish the use of those techniques in the ACL-ruptured patients. On the contrary, the Dynamic intraligamentary stabilization with Ligamys™ device demonstrated very promising results in different types of clinical studies.

Keywords: Bridge-enhanced ACL repair; Dynamic intraligamentary stabilization; Internal brace; Literature review; Primary ACL repair; Suture anchors.

Conflict of interest statement

Not applicable (Review article without involving animals, human participants, human data or human tissue).

Not applicable.

Michael-Alexander Malahias Dimitrios Chytas, Kaori Nakamura, Vasileios Raoulis, Masashi Yokota, and Vasileios Nikolaou declare that they have no competing interests.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Flow chart of study selection according to PRISMA guidelines for reporting systematic reviews and meta-analyses
Fig. 2
Fig. 2
Bar graph depicting the number of preclinical studies investigating the DIS technique, the BEAR, the ACL internal brace and the suture anchors ACL repair. DIS: dynamic intraligamentary stabilization, BEAR: bridge-enhanced ACL repair, Int. Brace: internal brace, Sut. Anchors: suture anchors, ACL: anterior cruciate ligament
Fig. 3
Fig. 3
Dynamic intraligamentary stabilization (DIS) with Ligamys™ device (figure supplied by and reproduced with permission from MATHYS European Orthopaedics)
Fig. 4
Fig. 4
Pie chart illustrating the proportion of clinical studies included in the review that dealt with DIS, BEAR, internal brace and suture anchors. DIS: dynamic intraligamentary stabilization, BEAR: bridge-enhanced ACL repair, Int. Brace: internal brace, Sut. Anchors: suture anchors, ACL: anterior cruciate ligament

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References

    1. Eichler K, Hess S, Riguzzi M, Can U, Brugger U. Impact evaluation of Swiss medical board reports on routine care in Switzerland: a case study of PSA screening and treatment for rupture of anterior cruciate ligament. Swiss Med Wkly. 2015;145:14140. - PubMed
    1. Mall NA, Chalmers PN, Moric M, Tanaka MJ, Cole BJ, Bach BR, Jr, et al. Incidence and trends of anterior cruciate ligament reconstruction in the United States. Am J Sports Med. 2014;42(10):2363–2370. doi: 10.1177/0363546514542796. - DOI - PubMed
    1. Biau DJ, Tournoux C, Katsahian S, Schranz PJ, Nizard RS. Bone-patellar tendon-bone autografts versus hamstring autografts for reconstruction of anterior cruciate ligament: meta-analysis. BMJ. 2006;332(7548):995–1001. doi: 10.1136/bmj.38784.384109.2F. - DOI - PMC - PubMed
    1. Herrington L. Functional outcome from anterior cruciate ligament surgery: a review. OA Orthop. 2013;1(2):12. doi: 10.13172/2052-9627-1-2-698. - DOI
    1. Muaidi QI, Nicholson LL, Refshauge KM, Herbert RD, Maher CG. Prognosis of conservatively managed anterior cruciate ligament injury: a systematic review. Sports Med. 2007;37(8):703–716. doi: 10.2165/00007256-200737080-00004. - DOI - PubMed

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