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Randomized Controlled Trial
. 2023 Mar 24;24(1):224.
doi: 10.1186/s13063-023-07127-0.

Suture-tape augmentation of anterior cruciate ligament reconstruction: a prospective, randomised controlled trial (STACLR)

Lachlan Huntington  1 , Andrew Griffith  2 , Libby Spiers  2 , Rebecca Pile  2 , Lachlan Batty  2 , Scott Tulloch  2 , Phong Tran  2
Affiliations
Randomized Controlled Trial

Suture-tape augmentation of anterior cruciate ligament reconstruction: a prospective, randomised controlled trial (STACLR)

Lachlan Huntington et al. Trials. .

Abstract

Background: Anterior cruciate ligament (ACL) reconstruction aims to restore anteroposterior and rotatory stability to the knee following ACL injury. This requires the graft to withstand the forces applied during the process of ligamentisation and the rehabilitative period. We hypothesise that the use of suture tape augmentation of single bundle ACL reconstruction (ACLR) will reduce residual knee laxity and improve patient-reported outcomes at 2-year follow-up. We will conduct a 1:1 parallel arm single-centre randomised controlled trial comparing suture tape augmented ACLR to standard ACLR technique.

Methods: The study design will be a parallel arm 1:1 allocation ratio randomised controlled trial. Sixty-six patients aged 18 and over waitlisted for primary ACLR will be randomised. Patients requiring osteotomy and extra-articular tenodesis and who have had previous contralateral ACL rupture or repair of meniscal or cartilage pathology that modifies the post-operative rehabilitation will be excluded. The primary outcome measure will be the side-to-side difference in anterior tibial translation (measured on the GNRB arthrometer) at 24 months post-surgery. GNRB arthrometer measures will also be taken preoperatively, at 3 months and 12 months post-surgery. Secondary outcomes will include patient-reported outcome measures (PROMs) collected online, including quality of life, activity and readiness to return to sport, complication rates (return to theatre, graft failure and rates of sterile effusion), examination findings and return to sport outcomes. Participants will be seen preoperatively, at 6 weeks, 3 months, 12 months and 24 months post-surgery. Participants and those taking arthrometer measures will be blinded to allocation.

Discussion: This will be the first randomised trial to investigate the effect of suture-tape augmentation of ACLR on either objective or subjective outcome measures. The use of suture-tape augmentation in ACLR has been associated with promising biomechanical and animal-level studies, exhibiting equivalent complication profiles to the standard technique, with initial non-comparative clinical studies establishing possible areas of advantage for the technique. The successful completion of this trial will allow for an improved understanding of the in situ validity of tape augmentation whilst potentially providing a further platform for surgical stabilisation of the ACL graft.

Trial registration: Australia New Zealand Clinical Trial Registry ACTRN12621001162808. Universal Trial Number (UTN): U1111-1268-1487. Registered prospectively on 27 August 2021.

Keywords: ACL; Anterior cruciate ligament; Arthrometer; Augmentation; GNRB; Orthopaedics; PROMs; RCT; Randomised controlled trial; Reconstruction; Suture tape; Tape.

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Conflict of interest statement

This study has been allocated funding by Arthrex Inc via the Investigator-Initiated Research Grant. This funding was sought and approved only following final protocol approval and ethical and local governance approval. This funding will be utilised to supply the GNRB for use in the study and for the employment of a part-time research assistant. All external funding sources had no input into the design or outcome of this study.

Figures

Fig. 1
Fig. 1
SPIRIT figure summarising outcomes and assessment schedule
Fig. 2
Fig. 2
Trial flow pathway
See this image and copyright information in PMC

References

    1. Noyes FR. The function of the human anterior cruciate ligament and analysis of single- and double-bundle graft reconstructions. Sports Health. 2009;1(1):66–75. doi: 10.1177/1941738108326980. - DOI - PMC - PubMed
    1. Moses B, Orchard J, Orchard J. Systematic review: annual incidence of ACL injury and surgery in various populations. Res Sports Med. 2012;20(3-4):157–179. doi: 10.1080/15438627.2012.680633. - DOI - PubMed
    1. Lewis DA, Kirkbride B, Vertullo CJ, Gordon L, Comans TA. Comparison of four alternative national universal anterior cruciate ligament injury prevention programme implementation strategies to reduce secondary future medical costs. Br J Sports Med. 2018;52(4):277–282. doi: 10.1136/bjsports-2016-096667. - DOI - PubMed
    1. Lohmander LS, Englund PM, Dahl LL, Roos EM. The long-term consequence of anterior cruciate ligament and meniscus injuries: osteoarthritis. Am J Sports Med. 2007;35(10):1756–1769. doi: 10.1177/0363546507307396. - DOI - PubMed
    1. Ardern CL, Webster KE, Taylor NF, Feller JA. Return to sport following anterior cruciate ligament reconstruction surgery: a systematic review and meta-analysis of the state of play. Br J Sports Med. 2011;45(7):596–606. doi: 10.1136/bjsm.2010.076364. - DOI - PubMed

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