Clinical experience with PDS II augmentation for operative treatment of acute proximal ACL ruptures - 2-year follow-up

The results of prospective anterior cruciate ligament (ACL) refixation in 3 3 patients with high proximal rupture is reported at 20-28 months' follow-u p: mean age was 31.1 +/- 12.5 years. The surgical technique was a specially developed refixation of the ACL using a multiple suture loop (modified Mar shall technique) augmented with intra-articular PDS TT (polydioxanon, resor bable, Ethicon, Hamburg, Germany) to avoid derangement of blood circulation and to guarantee early functional rehabilitation. All patients were operat ed on within 7.3 +/- 4.5 days after injury. According to the IKDC evaluatio n score, 22 patients showed excellent and 10 patients good subjective funct ion. Twenty regained their pre-injury level of activity. Anterior stability was tested manually and by KT-1000 max (Medmetric, San Diego). Twenty-eigh t patients had a firm end-paint, although there was a positive Lachman test in 16 patients. Maximal joint laxity as measured by KT-1000 showed a 1-2 m m, 3-5 mm, 6-10 mm and >10 mm anterior drawer for 16, 14, 2 and 1 patients, respectively. Twenty-five of the evaluated knee joints had a negative pivo t shift test. Three patients had a limited range of motion. The potential a dvantages of PDS II-augmented refixation of acute proximal ACL ruptures are anatomic reconstruction without destruction of other anatomic structures u sed as grafts, early functional rehabilitation and possibly better proprioc eption.