Altered Knee Loading Following Primary ACL Repair versus ACL Reconstruction.
Steven Singleton, Harrison Scofield, Brittany Davis and 4 others
PMID 37415672WHAT IT FOUND
At three months after surgery, people who had primary ACL repair showed greater loading symmetry during a single-leg squat and greater quadriceps strength symmetry than those who had bone-tendon-bone reconstruction.
Age differed, so this is not proof repair is better.
Key findings
01During the single limb squat, the ACL-r group had greater peak knee extension moment LSI (78.46±5.79%) and net knee joint power LSI (72.47±7.39%) than the ACL-R group, after controlling for age.
02The ACL-r group had greater quadriceps LSI (66.318±4.61%) than the ACL-R group (48.03±4.61%).
03No patients experienced major complications at final follow-up, including hospitalization, DVT or infection.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only 30 participants were tested at three months, so the finding may not hold in larger groups or over a longer recovery. The repair group was older than the reconstruction group (38.87±13.9 vs 25.60±11.78 years), and age was controlled for but may still affect recovery. Participants elected to undergo either repair or reconstruction, so other factors may explain the differences. All surgeries were performed by a single surgeon and rehabilitation followed the surgeon's protocol, so results may not apply to other surgeons or rehab approaches. The study measured loading only at three months, so it cannot say whether the differences persist, improve, or matter for long-term joint health. The authors state they cannot determine a direct relationship between ACL repair and improved knee loading.
Declared interests
The authors reported no relevant conflicts of interest.
The easy way to misread this
Do not conclude that primary ACL repair causes better knee loading or is the better surgery. This was a small comparison at three months in which patients elected repair or reconstruction, all surgeries were done by a single surgeon, and the repair group was older, so the difference may reflect those factors rather than the procedure itself.