Abstract | November 18, 2023

Posterior Cruciate Ligament Reconstruction with Suture Tape Augmentation: A Scoping Review

Cooper Root, BS, Medical Student, 3rd Year, KU School of Medicine, Wichita, KS

Michael Braman, BS, Medical Student, 2nd Year, KU School of Medicine, Kansas City, KS; Mukund Srinivas, MD, Orthopedics, PGY3, University of Kansas Medical Center, Kansas City, KS; Jonathen Ringenberg, MD, Orthopedics and Sports Medicine, PGY6, University of Kansas Medical Center, Kansas City, KS; Matthew Vopat, MD, Orthopedics and Sports Medicine, Assistant Professor, University of Kansas Medical Center, Kansas City, KS; Bryan Vopat, MD, Orthopedics and Sports Medicine, Associate Professor, University of Kansas Medical Center, Kansas City, KS

Learning Objectives

  1. Describe the current evidence that exists regarding suture tape augmentation for PCLR
  2. Identify the current gaps in the literature regarding suture tape augmentation of PCLR

Introduction: The posterior cruciate ligament (PCL) accounts for up to 20% of ligament injuries around the knee. Suture tape augmentation (STA) for PCL reconstruction (PCLR) is a novel concept to increase graft strength and prevent elongation. The purpose of this study is to conduct a scoping review assessing the evidence to support or oppose the use of PLCR with internal bracing in clinical practice.

Methods: A systematic search of three databases was performed following the PRISMA guidelines and was completed April 2023 to identify studies related to PCLR+STA. Surgical technique, animal, biomechanical, and clinical studies were included for review. Studies including revision surgery or PCL repairs were excluded.

Results: A total of 380 articles were identified in the search, 6 of which met inclusion criteria, including 1 technique, 3 biomechanical, and 2 clinical studies. Biomechanical studies showed significant reduction in PTT with PCLR+STA in multiple studies (p=0.047, p<0.05). STA was found to decrease total elongation by 45% (p=0.077) and 58% (p=0.018) in PCLR groups differing on tibial fixation of the graft complex (Adjustable loop device vs screw respectively); increased load to failure (p<0.012) was seen with STA compared to PCLR alone as well. Clinical studies showed no significant differences in patient reported outcome scores between PCLR+STA and PCLR alone, except for a decrease in Visual Analog Scale pain scores at rest in the STA group in one study (p=0.047). Another study showed significant increases in postoperative IKDC (84.52 ± 6.42, p<0.05), Lysholm (85.68 ± 4.99, p<0.05), and Tegner (6.71 ± 1.83, p<0.05) scores compared to preoperative scores along with normal range of motion and return to normal exercise in 93.5% of patients. There was no significant difference in complication rate between PCLR+STA and PCLR alone (p=0.232).

Conclusions: To our knowledge, this is the first review summarizing the literature regarding PCLR+STA. Biomechanical studies offer evidence showing beneficial load-sharing properties of increased graft strength and decreased elongation with STA. Clinical studies showed improved or equivalent outcomes to standard PCLR with no difference in complication rate. Larger sample sizes and longer-term data is necessary to understand the clinical benefit of STA of PCLR.

References and Resources

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Posted in: Surgery & Surgical Specialties67
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