Abstract
Objectives:
To evaluate the psychological readiness to return to sports (RTS), and assess the rates of RTS at preinjury level in patients undergoing anterior cruciate ligament (ACL) primary repair (ACLPR) with suture versus autograft ACL reconstruction (ACLR) at minimum 2-year follow-up (FU).
Methods:
Consecutive patients <50 years old and a preinjury Tegner score of ≥5, undergoing either ACLPR or ACLR by a single surgeon, between January 2018 and April 2021, were considered for eligibility. Surgical indication for either ACLPR with suture augmentation or autograft ACLR (58% hamstring- and 42% quadriceps tendon graft) was based on intra-operatively determined ACL tear type and tissue quality. ACLPR was performed in all patients with proximal type I or II types and good to excellent tissue quality, whereas ACLR was only performed when tear characteristics contraindicated ACL repair. To evaluate success of RTS, activity level (Tegner Activity Scale), psychological readiness to RTS (ACL-Return to Sport After Injury [RSI] score) and instrumented anterior-tibial translation side-to-side difference (ATT-SSD) were evaluated at minimum 2-year FU.
Results:
A total of 181 patients (100 ACLPR, 81 ACLR), were evaluated at final FU (mean ± SD (range), 3.2 ± 0.9 (2 to 5) years). A significantly greater number of patients undergoing ACLPR returned to their preinjury activity level (73% vs. 47%, p < .001), and further presented significantly better ACL-RSI scores (75.3 ± 22.2 vs. 66.6 ±24.2, p = .023) at minimum 2-year FU. Instrumented knee laxity revealed similar results for both treatment groups (ACLPR, 0.80 ±1.2 mm vs. ACLR, 0.97 ± 1.2 mm, p = .449).
Conclusions:
Patients undergoing ACLPR demonstrate greater return to preinjury activity level and greater confidence in their operated knee when performing their respective sport at 2-year FU compared to ACLR.