BACKGROUND Anterior cruciate ligament (ACL) repair has once again become a focus of research because of the development of new techniques. PURPOSE/HYPOTHESIS The purpose of the present study was to compare the functional results and recurrent instability rates in patients undergoing ACL repair with dynamic intraligamentary stabilization (DIS) versus primary ACL reconstruction (ACLR) for acute isolated ACL tears. The hypothesis was that functional results and knee joint stability after ACL repair with DIS would be comparable with that after ACLR. STUDY DESIGN Randomized clinical trial; Level of evidence, 1. METHODS A total of 85 patients with acute ACL tears were randomized to undergo either ACL repair with DIS or primary ACLR. The preinjury activity level and function were recorded. Follow-up examinations were performed at 6 weeks and 6, 12, and 24 months postoperatively. Anterior tibial translation (ATT) was evaluated using Rolimeter testing. The Tegner activity scale, International Knee Documentation Committee (IKDC) subjective form, and Lysholm knee scoring scale scores were obtained. Clinical failure was defined as ΔATT >3 mm in combination with subjective instability. Recurrent instability and other complications were recorded. RESULTS There were 83 patients (97.6%) who were successfully followed until 2 years. ATT was significantly increased in the DIS group compared with the ACLR group (ΔATT, 1.9 vs 0.9 mm, respectively; P = .0086). A total of 7 patients (16.3%) in the DIS group had clinical failure and underwent single-stage revision. In the ACLR group, 5 patients (12.5%) had failure of the reconstruction procedure; 4 of these patients required 2-stage revision. The difference in the failure rate was not significant (P = .432). There were 4 patients (3 in the DIS group and 1 in the ACLR group) who showed increased laxity (ΔATT >3 mm) without subjective instability and did not require revision. Recurrent instability was associated with young age (<25 years) and high Tegner scores (>6) in both groups. No significant differences between ACL repair with DIS and ACLR were found for the Tegner, IKDC, and Lysholm scores at any time. CONCLUSION Whereas ATT measured by Rolimeter testing was significantly increased after ACL repair with DIS, clinical failure was similar to that after ACLR. In addition, functional results after ACL repair with DIS for acute tears were comparable with those after ACLR. The current study supports the use of ACL repair with DIS as an option to treat acute ACL tears. REGISTRATION DRKS00015466 (German Clinical Trials Register).

中文翻译：

---

动态韧带修复与急性前交叉韧带眼泪的初次重建的前瞻性随机研究的2年结果。

背景技术由于新技术的发展，前十字韧带（ACL）修复再次成为研究的重点。目的/假设本研究的目的是比较接受动态韧带稳定（DIS）相对于原发ACL重建（ACLR）进行急性孤立ACL撕裂的ACL修复患者的功能结果和复发不稳定性率。假设是，DIS进行ACL修复后的功能结果和膝关节稳定性与ACLR后相当。研究设计随机临床试验；证据级别：1。方法随机将85例急性ACL撕裂患者随机接受DIS或原发性ACLR进行ACL修复。记录损伤前的活动水平和功能。在第6周和第6、12周进行了随访检查 术后24个月。使用Rolimeter测试评估胫骨前平移（ATT）。获得Tegner活动量表，国际膝关节文献委员会（IKDC）的主观表格和Lysholm膝关节评分量表分数。临床失败定义为ΔATT> 3 mm并伴有主观不稳定性。记录复发性不稳定性和其他并发症。结果成功随访至2年的患者83例（97.6％）。与ACLR组相比，DIS组的ATT显着增加（ΔATT分别为1.9和0.9 mm； P = 0.0086）。DIS组中共有7例患者（16.3％）出现临床衰竭并接受了单阶段翻修。在ACLR组中，有5例（12.5％）的重建手术失败；这些患者中有4位需要进行2期翻修。故障率的差异不明显（P = .432）。有4例患者表现出松弛度增加（ΔATT> 3 mm）而无主观不稳定性且不需要矫正（其中DIS组3例，ACLR组1例）。两组的复发性不稳定性均与年轻（<25岁）和高Tegner评分（> 6）相关。在任何时候，Tegner，IKDC和Lysholm评分在DIS和ACLR的ACL修复之间均未发现明显差异。结论用散光光度计测得的ATT在ACL修复DIS后明显增加，但临床失败率与ACLR相似。此外，用DIS进行ACL修复急性泪液后的功能结果与ACLR后相当。目前的研究支持使用DIS进行ACL修复作为治疗急性ACL眼泪的一种选择。