The gold standard treatment for Anterior Cruciate Ligament injury is reconstruction (ACL-R). Graft failure is the concern and ensuring a durable initial graft with rapid integration is crucial. Graft augmentation with implantable devices (internal brace reinforcement) is a technique purported to reduce the risk of rupture and hasten recovery. We aim to compare the short-term outcome of ACL-R using augmented hamstring tendon autografts (internally braced with neoligament) and non-augmented hamstring autografts. This was a retrospective cohort study comparing augmented and non-augmented ACL-R. All procedures were performed in a single centre using the same technique. The Knee injury and Osteoarthritis Outcome Score [KOOS] was used to assess patient-reported outcomes.Abstract
Background
Methods
The gold standard treatment for Anterior Cruciate Ligament injury is reconstruction (ACL-R). Graft augmentation with suture tape (internal brace) are techniques purported to reduce the risk of rupture and hasten recovery. Our aim was to assess the short-term outcome of ACL-R using fibre tape augmented and non-augmented hamstring tendon grafts. This was a retrospective comparative study looking at augmented and non-augmented ACL-R. All procedures were performed by a single surgeon in a single centre using the same technique. The Knee injury and Osteoarthritis Outcome Score [KOOS] was used to assess patient-reported outcomes.Abstract
Background
Methods
Between 1989 and 1992 102 knees adjudged suitable for Unicompartmental replacement (UKR) were randomised to receive either a St Georg Sled UKR or a Kinematic modular total knee replacement (TKR). The early results demonstrated that the UKR group had less complications, and more rapid rehabilitation. At 5 years there were equal failures but the UKR group had more excellent results and a greater range of movement. Despite this doubt persisted about whether these advantages would be maintained these cases have been followed regularly by a research nurse at 8, 10, 12 years. We now report the final outcome at 15 years. 43 patients (45 knees) have died with all their knees intact. Throughout the review period the Bristol Knee Scores (BKS) of the UKR group have been better and at 15 years 77% and 53% of the surviving UKRs and TKRs achieve an excellent score. 6 TKRs and 4 UKRs have failed during the 15 years of the review. The better early results with UKR are maintained at 15 years with no greater failure rate. The median BKS scores of the UKR group was 91.1 at five years and 92 at 15 years suggesting little functional deterioration in either the prosthesis or remainder of the joint. These results would seem to justify the increased use of UKR.Conclusion
