Dynamic intraligamentary stabilization versus conventional ACL reconstruction: A matched study on return to work

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Regenerative Medicine

Background:

• Anterior Cruciate Ligament (ACL) injuries are common, often requiring surgical reconstruction (ACLR).
• Dynamic Intraligamentary Stabilization (DIS) is an alternative technique aiming for ligament self-healing in acute injuries (<21 days).
• Comparative data on DIS versus ACLR outcomes is limited.

Purpose of the Study:

• To compare Dynamic Intraligamentary Stabilization (DIS) and Anterior Cruciate Ligament Reconstruction (ACLR).
• Outcomes assessed include work incapacity, revision rates, secondary arthroscopies, and treatment costs.
• Focus on acute ACL injuries within 21 days.

Main Methods:

• Post-hoc analysis of prospectively collected data from the Swiss National Accident Insurance Fund (SUVA).
• 53 DIS cases were matched to ACLR cases using propensity score analysis.
• A 2-year follow-up period was used to compare outcomes via paired Student's T-test and Chi-square test.

Main Results:

• Mean time to surgery was significantly shorter for DIS (14 days) vs. ACLR (50 days).
• DIS patients experienced 13% work incapacity, compared to 17% for ACLR, a difference of nearly one month of work absence.
• No significant differences were observed in treatment costs, secondary arthroscopies, or revision rates between DIS and ACLR.

Conclusions:

• Dynamic Intraligamentary Stabilization (DIS) leads to significantly shorter work absence compared to ACL reconstruction.
• Early surgical timing in DIS is likely responsible for reduced work incapacity.
• DIS is a viable treatment option for acute ACL injuries, with outcomes comparable to ACLR in terms of costs and revisions.