Arthroscopic Anterior Cruciate Ligament Repair With Suture Augmentation Provides Good to Excellent Midterm Functional Outcomes Despite Clinically Relevant Revision Rates.
4 affiliations
- 1Department of Orthopaedics and Trauma Surgery BG Unfallklinik Frankfurt am Main Frankfurt am Main Germany.
- 2Department of Orthopaedics and Tumor Orthopaedics University Hospital of Münster Münster Germany.
- 3Department of Hematology and Oncology Including Pneumology University Medical Center Hamburg-Eppendorf (UKE) Hamburg Germany.
- 4Department of Orthopaedics and Trauma Surgery Klinik Gut St. Moritz Switzerland.
Abstract
Purpose
To evaluate midterm functional outcomes after anterior cruciate ligament (ACL) repair with suture augmentation and to determine whether concomitant injuries influence patient-reported outcomes.Methods
This retrospective single-center cohort study included patients undergoing arthroscopic ACL repair with suture augmentation between January 2017 and March 2019. Eligible patients had proximal ACL tears (Sherman type I-II) with adequate tissue quality at a minimum 6-year follow-up. Patient-reported outcome measures included the International Knee Documentation Committee, Lysholm score, Tegner activity score, and forgotten joint score. Multivariate regression analysis was performed to identify predictors of postoperative outcomes. Clinically meaningful improvement was assessed using the minimal clinically important difference.Results
Of 93 patients, 80 (86%) were available for follow-up. Thirteen patients (16.3%) underwent revision surgery, all consisting of ACL reconstruction, at a median time of 35 months (interquartile range [IQR] 8-49) and were excluded, leaving 67 patients for evaluation. At a median follow-up of 79 months (IQR 75-97), median International Knee Documentation Committee was 94 (IQR 71-100); Lysholm score, 92 (IQR 74-100); and forgotten joint score, 86 (IQR 65-94). Median Tegner activity score decreased from 7 (IQR 4-10) preinjury to 6 (IQR 4-9) postoperatively (P = .03), remaining within the minimal clinically important difference in 74.6% of patients. Concomitant meniscal (n = 41) and ligamentous injuries (n = 63) were addressed intraoperatively and did not significantly affect patient-reported outcome measures. Delayed surgery was the only independent predictor of lower postoperative Tegner activity scores (β = -0.79, P = .025).Conclusions
Arthroscopic ACL repair with suture augmentation achieved good to excellent midterm functional outcomes in a 6-year follow-up, with 74.6% of patients maintaining activity levels within the minimal clinically important difference threshold. However, the revision rate of 16.3% remains clinically relevant. Concomitant ligamentous and meniscal lesions of low severity did not result in inferior patient-reported outcomes in this cohort.Level of evidence
Level IV, retrospective therapeutic case series.
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BibTeX
@article{egert2026arthroscopic,
title = {{Arthroscopic Anterior Cruciate Ligament Repair With Suture Augmentation Provides Good to Excellent Midterm Functional Outcomes Despite Clinically Relevant Revision Rates.}},
author = {Anna Patricia Egert and Kristian Nikolaus Schneider and Georg Gosheger and Jan Christoph Theil and Jan Frederic Weller and Alexander Klug and Georg Ahlbäumer},
journal = {Arthroscopy, sports medicine, and rehabilitation},
year = {2026},
month = oct,
doi = {10.1002/ars2.70128},
url = {https://europepmc.org/article/MED/42921574},
note = {CC BY},
}
RIS
TY - JOUR
TI - Arthroscopic Anterior Cruciate Ligament Repair With Suture Augmentation Provides Good to Excellent Midterm Functional Outcomes Despite Clinically Relevant Revision Rates.
AU - Anna Patricia Egert
AU - Kristian Nikolaus Schneider
AU - Georg Gosheger
AU - Jan Christoph Theil
AU - Jan Frederic Weller
AU - Alexander Klug
AU - Georg Ahlbäumer
PY - 2026
DA - 2026/10/23
JO - Arthroscopy, sports medicine, and rehabilitation
DO - 10.1002/ars2.70128
UR - https://europepmc.org/article/MED/42921574
AB - Purpose To evaluate midterm functional outcomes after anterior cruciate ligament (ACL) repair with suture augmentation and to determine whether concomitant injuries influence patient-reported outcomes.Methods This retrospective single-center cohort study included patients undergoing arthroscopic ACL repair with suture augmentation between January 2017 and March 2019. Eligible patients had proximal ACL tears (Sherman type I-II) with adequate tissue quality at a minimum 6-year follow-up. Patient-reported outcome measures included the International Knee Documentation Committee, Lysholm score, Tegner activity score, and forgotten joint score. Multivariate regression analysis was performed to identify predictors of postoperative outcomes. Clinically meaningful improvement was assessed using the minimal clinically important difference.Results Of 93 patients, 80 (86%) were available for follow-up. Thirteen patients (16.3%) underwent revision surgery, all consisting of ACL reconstruction, at a median time of 35 months (interquartile range [IQR] 8-49) and were excluded, leaving 67 patients for evaluation. At a median follow-up of 79 months (IQR 75-97), median International Knee Documentation Committee was 94 (IQR 71-100); Lysholm score, 92 (IQR 74-100); and forgotten joint score, 86 (IQR 65-94). Median Tegner activity score decreased from 7 (IQR 4-10) preinjury to 6 (IQR 4-9) postoperatively (P = .03), remaining within the minimal clinically important difference in 74.6% of patients. Concomitant meniscal (n = 41) and ligamentous injuries (n = 63) were addressed intraoperatively and did not significantly affect patient-reported outcome measures. Delayed surgery was the only independent predictor of lower postoperative Tegner activity scores (β = -0.79, P = .025).Conclusions Arthroscopic ACL repair with suture augmentation achieved good to excellent midterm functional outcomes in a 6-year follow-up, with 74.6% of patients maintaining activity levels within the minimal clinically important difference threshold. However, the revision rate of 16.3% remains clinically relevant. Concomitant ligamentous and meniscal lesions of low severity did not result in inferior patient-reported outcomes in this cohort.Level of evidence Level IV, retrospective therapeutic case series.
SN - 2666-061X
ER -