Knee ligament reconstruction reinforced with FiberTape®: Versatility in indications and safety profile of 381 cases with a mean follow up of 8 years.

BACKGROUND

Suture tape reinforcement of knee ligament reconstruction differs from graft augmentation as a concept in technique and biomechanics. The former allows independent loading of the graft and a stronger construct. The purpose of this study was to report the clinical outcomes and complications rate of a large series of knee ligament reconstructions reinforced with a high-strength suture tape.

METHODS

A retrospective review of a prospectively maintained single-centre knee ligament surgery database that includes 1685 cases performed between March 2011 to June 2022 was conducted. Three hundred and eighty-one cases that underwent ligament reconstruction with ultra-high-strength suture tape reinforcement were included in the study and categorized into three groups: Group I - cases of anterior cruciate ligament reconstruction (ACLR); Group II - cases of multi-ligament knee injuries with ACL involvement, where reconstruction/repair was performed for all the injured structures; Group III - isolated ligament reconstruction cases or multi-ligament injuries with no ACL involvement. Patients were clinically evaluated preoperatively and at 6, 12 and 24 months postoperatively. Objective knee stability testing with KT-1000 arthrometer was reported. Range of motion and patient-reported outcome measures (PROMs) including the Knee Injury and Osteoarthritis Outcome (KOOS) score, Lysholm score and Tegner activity score, were reported. All complications and their treatments were reported.

RESULTS

A total of 381 cases of primary ligament reconstruction, where one or more ligament was reinforced with high-strength suture tape were included. Group I ACL (n = 234), Group II Multi-ACL (n = 92), Group III Other-Ligament(s) (n = 55). The total mean age was 30.5 ± 12.3 years, 64.6% were males and 35.4% females. The mean follow up for all cases was 8 ± 2.8 years (range 7.7-8.3). Subjective knee stability with KT-1000 arthrometer demonstrated significant postoperative improvements across all groups (all P < 0.05). The side-to-side difference at 2 years in Group I was 1.7 ± 3.3 mm (P = 0.03), in Group II was 1.1 ± 3.2 mm (P = 0.04), while Group III exhibited a side-to-side difference of 1 ± 3.6 mm (P < 0.001), indicating that anteroposterior stability had been restored in all groups There was significant clinical improvement across all PROMs from preoperative to the 24 months postoperative mark (all P < 0.05). Overall complications were reported in 3.7% (n = 14/381) of the cases, including 2.1% (n = 5/234) ACL re-rupture rate. No other ligament re-rupture was reported.

CONCLUSION

Knee ligament reconstruction with high-strength suture tape reinforcement yields a safe graft-suture construct that translates into favourable clinical outcomes for both intra-articular and extra-articular ligament surgery, with a very low complication rate including a low graft rupture rate.