Splint-based treatment may yield high restoration rate for ACL

Issue: July/August 2015

LYON, France — A splint-based conservative treatment yielded the same high rate of anatomical and functional restoration of the ACL as seen in a smaller, previously reported study, according to results presented at the International Society for Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine Biennial Congress, here.

Using diffusion-weighted MRI sequences, Cyrille Delin, MD, and colleagues selected 90 cases (mean age: 32 years) of fully ruptured ACL with no displacement of ligament fibers and placed the patients’ knees in a load-bearing splint for 6 weeks with a range of motion of 30° to 60° flexion. MRI was used to check the continuity of the patients’ ligaments.

At 10 months after the initial trauma, patients underwent clinical examination, stress radiography and MRI to assess functional status and the anatomical aspect of the ligaments. Patients were re-examined once more during the course of a 3-year period to check the healed ACL and undergo a clinical and functional evaluation.

Results showed fully restored ACL anatomy on distance MRIs among 73 patients and full healing of the ACL among 66 patients. Significant residual clinical laxity was present in 7.8% of patients, according to study results. However, Delin noted this had no functional impact. Of the failures reported, results showed four cases where the ACL was replaced by non-functional scar tissue, seven cases of non-healing and six rupture recurrences. Results also showed revision with ACL reconstruction occurred in 12 cases.

“After 6 weeks, the ACLs became continuous with the diffusion-weighted sequence,” Delin said. “After 10 months, the ACL is back to normal.” – by Casey Tingle

Reference:

Delin C, et al. Paper #93. Presented at: International Society for Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine Biennial Congress; June 7-11, 2015; Lyon, France.

Disclosure: Delin reports no relevant financial disclosures.