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Arthroscopic Primary Repair of Fresh Partial ACL Tears

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Sports Injuries

Abstract

Fresh subtotal ACL tears have been reported to have the ability to heal with the help of subchondral bleeding spontaneously or by provoked bleeding in the avulsion of the notch. Within an orienting prospective study, 55 fresh partial (50–80%) ACL injuries were treated with arthroscopic primary repair to demonstrate the effect of provoked healing. The torn ACL bundles were re-adapted and the anatomical onsets at the bone were perforated in order to provoke a healing response from a super clot with mesenchymal stem cells. If re-insertion and reduction was difficult, an additional arthroscopic fixation with a suture anchor had to be performed. The knee rehabilitation was performed mainly in extended position and limited range of motion within the first 3 weeks, providing unloading for the ACL. Clinical and MRI follow-ups were performed at 6, 12, and 24 months. The median Tegner activity score performed from 2 to 5 points after 24 months. The mean Lysholm knee-score improved from 41 to 92 points after 24 months. The MRI showed morphological changes, with unorganized ligament fibers changing to continuous end-to-end appearance – mostly with a normal thickness and with hypertrophy or atrophy in a few cases. The KT-1000 measurement showed an improvement in stability from 3.4 to 2 mm mean value. Eleven (17%) cases showed failures within the first 12 months with inadequate stability (four) or recurrent trauma (seven) during sports activity. In mid-term time response, arthroscopic primary repair is a minimally invasive, easy, and inexpensive procedure that shows an 83% success rate if applied in fresh partial ACL tears.

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Authors and Affiliations

  1. Clinic and Polyclinic for Orthopaedic Surgery, University Hospital Giessen-Marburg GmbH, Paul-Meimberg Str 3, 35392, Giessen, Germany

    Erhan Basad, Henning Stürz & Bernd Ishaque

  2. Clinic and Policlinic for Common- and Visceral Surgery, Wurzburg University Hospital, Oberduerrbacherstr. 6, 97080, Wurzburg, Germany

    Leo Spor

Authors
  1. Erhan Basad
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  2. Leo Spor
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  3. Henning Stürz
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  4. Bernd Ishaque
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Correspondence to Erhan Basad .

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Editors and Affiliations

  1. Fac. Medicine, Dept. Orthopedics & Traumatology, Hacettepe University, Hasyrcylar Caddesi, Ankara, 94110, Turkey

    Mahmut Nedim Doral

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© 2012 Springer-Verlag Berlin Heidelberg

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Basad, E., Spor, L., Stürz, H., Ishaque, B. (2012). Arthroscopic Primary Repair of Fresh Partial ACL Tears. In: Doral, M. (eds) Sports Injuries. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-15630-4_52

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  • DOI: https://doi.org/10.1007/978-3-642-15630-4_52

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-15629-8

  • Online ISBN: 978-3-642-15630-4

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