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Bridge-enhanced ACL repair yielded outcomes similar to hamstring autograft ACL reconstruction

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LAS VEGAS — Patients who underwent bridge-enhanced ACL repair experienced no adverse reactions and had outcomes similar to patients who underwent ACL reconstruction with autograft quadruple-bundle hamstring tendon, according to results presented at the Arthroscopy Association of North American and American Orthopaedic Society for Sports Medicine Specialty Day at the American Academy of Orthopaedic Surgeons Annual Meeting.

Martha M. Murray, MD, and colleagues assessed IKDC objective and subjective scores and KT-1000 testing for anteroposterior laxity and functional testing up to 2-years postoperatively among patients undergoing either bridge-enhanced ACL repair (n=10) or a hamstring autograft ACL reconstruction (n=10).

“We had no revision ACL surgery that was required in either group at the 2-year time point,” Murray said in her presentation here.

In both groups, 20% of patients needed an additional surgery during the 2-year time point, according to Murray. She added both groups had significant improvements in IKDC and KOOS scores from baseline.

“In this study, the ACL grafts came in with a side-to-side difference of 3.3 mm,” Murray said. “The [bridge-enhanced ACL repair] BEAR patients came in with a mean of 1.9 mm.”

Murray noted patients in the ACL reconstruction group had a persistent deficit in hamstring strength compared with the bridge-enhanced ACL repair group. MRI obtained at 24 months for nine patients in the bridge-enhanced ACL repair group showed tissue bridging from femoral insertion site to tibial insertion site, she said.

“There was biologic variability in the signal intensity with some patients having a low signal intensity consistent with highly recognized collagenous tissue, while other patients had a slightly higher signal intensity consistent with less organized tissue,” Murray said. “When we do a follow-up MRI on the grafts, we saw a similar thing where, again, some patients had a strongly organized graft while other patients had higher signal intensity conceptions within the graft.” – by Casey Tingle

Reference:

Murray MM, et al. Abstract 7. Presented at: Arthroscopy Association of North American and American Orthopaedic Society for Sports Medicine Specialty Day at the American Academy of Orthopaedic Surgeons Annual Meeting; March 16, 2019; Las Vegas.

Disclosure: Murray reports she is a founder and equity holder of Miach Orthopaedics.