J Knee Surg 2012; 25(03): 255-260
DOI: 10.1055/s-0032-1313742
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Outcomes Following Healing Response in Older, Active Patients: A Primary Anterior Cruciate Ligament Repair Technique

J. Richard Steadman
1   The Steadman Clinic, Steadman Philippon Research Institute, Vail, Colorado
,
Lauren M. Matheny
1   The Steadman Clinic, Steadman Philippon Research Institute, Vail, Colorado
,
Karen K. Briggs
1   The Steadman Clinic, Steadman Philippon Research Institute, Vail, Colorado
,
William G. Rodkey
1   The Steadman Clinic, Steadman Philippon Research Institute, Vail, Colorado
,
Dominic S. Carreira
2   Broward Health Orthopedics and Sports Medicine, Fort Lauderdale, Florida
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Publikationsverlauf

02. Februar 2011

28. Dezember 2011

Publikationsdatum:
21. Mai 2012 (online)

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Abstract

The purpose of this study was to document outcomes following the healing response procedure for treatment of complete, proximal anterior cruciate ligament (ACL) tears in a mature, active population. Healing response is an all-arthroscopic procedure that preserves the native ACL and makes use of an arthroscopic awl with a 45-degree angle to make holes in the femoral attachment of the ACL and in the body of the ACL. Patients were included in this IRB-approved study if they were ≥40 years old, had a complete proximal ACL tear, and who had healing response within 6 weeks of initial injury. In this study 48 patients (35 females, 13 males) with an average age of 51 years (range: 41 to 68 years) underwent the healing response procedure. Of these four female patients (8.9%) required subsequent ACL reconstruction. Mean time to ACL reconstruction was 34.5 months (range, 14.3 to 61.2 months). Of the 44, 41 patients (93%) had minimum of 2-year follow-up at an average of 7.6 years (range, 2.2 to 13.4 years). Average preoperative Lysholm score was 54 (range, 10 to 82) and improved to an average of 90 postoperatively (p = 0.001). Median Tegner Activity Scale at follow-up was 5 (range, 2 to 9). Median patient satisfaction was 10 (range, 4 to 10). Higher patient satisfaction was correlated with increased Lysholm score at follow-up (rho = 0.39, p = 0.02). Tegner Activity Scale was associated with postoperative Lysholm score (rho = 0.35, p = 0.04). This study demonstrates the effectiveness of the healing response procedure to allow patients to return to high levels of recreational activity and to restore knee function to normal levels. In a select group of mature patients with acute proximal ACL tears, the healing response procedure is an effective treatment technique.