M. Enes Kayaalp1, Serkan Sürücü2, Mehmet Halis Çerçi3, Mahmut Aydın4, Mahir Mahiroğulları5

1Department of Orthopedics and Traumatology, Kartal Dr. Lütfi Kırdar Training and Research Hospital, Istanbul, Türkiye
2Department of Orthopedics, University of Missouri Kansas City, Kansas City, United States
3Department of Orthopedics and Traumatology, Istanbul Arel University, Istanbul, Türkiye
4Department of Orthopedics and Traumatology, Istanbul Haseki Training Hospital, Istanbul, Türkiye
5Department of Orthopedics and Traumatology, Şişli Memorial Hospital, Istanbul, Türkiye

Keywords: Anterior cruciate ligament, anterior cruciate ligament injury, anterior cruciate ligament reconstruction, anterior cruciate ligament repair, return to sport.


Objectives: This study aims to comparatively evaluate early to midterm clinical results of case-matched patient groups of primary repairs with dynamic intraligamentary stabilization (DIS) or all-inside anterior cruciate ligament (ACL) reconstruction (ACLR) by an independent group.

Patients and methods: Between March 2015 and September 2018, a total of 16 patients operated for ACL injuries with the repair technique were retrospectively identified. Cases were stratified by treatment: DIS technique versus all-inside ACLR and matched at a ratio of 1:2. The ACLR patients were selected from a patient group with an injury-tooperation time interval of fewer than three months. A total of 32 patients were included in the all inside ACLR group. Pre-injury and postoperative International Knee Documentation Committee (IKDC) subjective score, Tegner and Lysholm scores had been obtained. Additionally, ACLReturn to Sport after Injury (ACL-RSI) scale scores, clinical results, and complications were noted.

Results: One (6%) patient in the DIS group and two (6%) patients in the ACLR group were lost-to-follow-up and, for a total of 45 patients, 15 in the DIS group and 30 in the ACLR group, were included in the study. The mean postoperative follow-up was 50.8±13.5 months and 48.2±11.4 months in the DIS and ACLR groups, respectively. The Tegner, Lysholm, and IKDC subjective scores were non-significantly different between the groups at any time points. The ACL-RSI scale scores were significantly higher at six (p<0.001) and 12 (p=0.01) months in the repair group. The pivot-shift test was negative in all cases postoperatively. One re-rupture occurred in each group. The reoperation rate at any cause was 25% for the repair and 10% for the ACLR group.

Conclusion: Primary ACL repair using the DIS technique provides a similar clinical outcome to these by an all-inside ACLR technique in moderately active patients. The DIS technique is reliable and reproducible, and associated with an early and speedier psychological recovery in a carefully selected, non-athlete patient group as observed by an independent group.

Citation: Kayaalp ME, Sürücü S, Çerçi MH, Aydın M, Mahiroğulları M. Anterior cruciate ligament repair using dynamic intraligamentary stabilization provides a similarly successful outcome as allinside anterior cruciate ligament reconstruction with a faster psychological recovery in moderately active patients. Jt Dis Relat Surg 2022;33(2):406-413.

Ethics Committee Approval

The study protocol was approved by the Istanbul Memorial Şişlis Hospital Ethics Committee (date/no: 26.02.2021/03). The study was conducted in accordance with the principles of the Declaration of Helsinki.

Author Contributions

All authors contributed equally in the creation of this manuscript

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.