Intermediate Duration Outcomes After Hamstring Anterior Cruciate Ligament Reconstruction Comparing Adolescents With...

Suture tape reinforcement (STR) as an adjunct to hamstring anterior cruciate ligament (ACL) reconstruction in adolescent athletes has demonstrated improved patient-reported outcome (PRO) scores up to 2 years postoperatively. Our hypothesis is that STR in ACL reconstruction would result in similar PROs at intermediate follow-up (minimum of 3 years) compared to reconstruction without STR in adolescent athletes.

A retrospective review was conducted on adolescent patients who underwent hamstring autograft ACL reconstruction at a single institution with and without STR with a minimum of 3-year follow-up duration, as long as PROs were available. The collected PRO measures included Lysholm, the Single Assessment Numeric Evaluation (SANE), Tegner, pain, and patient satisfactions scores. Return to sport (RTS) was defined as the patient-reported ability to return to pre-injury level of sport. Complications included graft failure, meniscus pathology, arthrofibrosis, STR failure, or feelings of knee instability.

Forty-two patients (21 STR and 21 no-STR) had completed PROs at a mean of 5.1 ± 1.2 years (STR mean 6.2 ± 0.3 years versus no-STR mean 3.9 ± 0.7 years; P < .001). Non-graft-related complications were similar among the two cohorts (6/21 STR patients and 5/21 no-STR patients, P = 1.0). There was no significant difference in the Lysholm score, the SANE, the Tegner score, pain, or satisfaction between cohorts (P > .09). STR ACL reconstructions satisfactorily returned to pre-injury sport in 20 of 21 STR patients (95%) compared to only 10 of 21 no-STR patients (48%; P = .001).

STR in ACL hamstring autograft reconstruction is associated with a higher likelihood of RTS even with a longer duration of follow-up. PROs were not diminished with longer duration follow-up and the absence of complications related to utilization of a suture tape appears to support the utilization of STR for this high-risk adolescent athlete population undergoing autograft hamstring ACL reconstruction.

(1)Anterior cruciate ligament reconstruction with and without suture tape reinforcement (STR) have similar patient-reported outcomes.(2)STR maintains reduced graft failure rates.(3)STR may increase the likelihood of return to sports.

III, case-control series.