Skip to main content

05.02.2018 | Knee | Ausgabe 10/2018

Knee Surgery, Sports Traumatology, Arthroscopy 10/2018

Surgeon experience with dynamic intraligamentary stabilization does not influence risk of failure

Knee Surgery, Sports Traumatology, Arthroscopy > Ausgabe 10/2018
Philipp Henle, Kathrin S. Bieri, Janosch Haeberli, Nele Arnout, Jan Victor, Mirco Herbort, Clemens Koesters, Stefan Eggli
Wichtige Hinweise
A correction to this article is available online at https://​doi.​org/​10.​1007/​s00167-018-5096-y.



Studies on dynamic intraligamentary stabilization (DIS) of acute anterior cruciate ligament (ACL) ruptures reported failure rates similar to those of conventional ACL reconstruction. This study aimed to determine whether surgeon experience with DIS is associated with revision rates or patient-reported outcomes. The hypothesis was that more experienced surgeons achieved better outcomes following DIS due to substantial learning curve.


The authors prospectively enrolled 110 consecutive patients that underwent DIS and evaluated them at a minimum of 2 years. The effects of independent variables (surgeon experience, gender, age, adjuvant procedures, tear location, preinjury Tegner score, time from injury to surgery, and follow-up) on four principal outcomes (revision ACL surgery, any re-operation, IKDC and Lysholm score) were analyzed using univariable and multivariable regressions.


From the 110 patients enrolled, 14 patients (13%) were lost to follow-up. Of the remaining 96 patients, 11 underwent revision ACL surgery, leaving 85 patients for clinical assessment at a mean of 2.2 ± 0.4 years (range 2.0–3.8). Arthroscopic reoperations were performed in 26 (27%) patients, including 11 (11%) revision ACL surgeries. Multivariable regressions revealed: (1) no associations between the reoperation rate and the independent variables, (2) better IKDC scores for ‘designer surgeons’ (b = 10.7; CI 4.9–16.5; p < 0.001), higher preinjury Tegner scores (b = 2.5, CI 0.8–4.2; p = 0.005), and younger patients (b = 0.3, CI 0.0–0.6; p = 0.039), and (3) better Lysholm scores for ‘designer surgeons’ (b = 7.8, CI 2.8–12.8; p = 0.005) and preinjury Tegner score (b = 1.9, CI 0.5–3.4; p = 0.010).


Surgeon experience with DIS was not associated with rates of revision ACL surgery or general re-operations. Future, larger-scaled studies are needed to confirm these findings. Patients operated by ‘designer surgeons’ had slightly better IKDC and Lysholm scores, which could be due to better patient selection and/or positively biased attitudes of both surgeons and patients.

Level of evidence

Level II, prospective comparative study.

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

e.Med Interdisziplinär

Mit e.Med Interdisziplinär erhalten Sie Zugang zu allen CME-Fortbildungen und Fachzeitschriften auf Zusätzlich können Sie eine Zeitschrift Ihrer Wahl in gedruckter Form beziehen – ohne Aufpreis.

Weitere Produktempfehlungen anzeigen
Über diesen Artikel

Weitere Artikel der Ausgabe 10/2018

Knee Surgery, Sports Traumatology, Arthroscopy 10/2018 Zur Ausgabe
  1. Sie können e.Med Orthopädie & Unfallchirurgie 14 Tage kostenlos testen (keine Print-Zeitschrift enthalten). Der Test läuft automatisch und formlos aus. Es kann nur einmal getestet werden.

Neu im Fachgebiet Orthopädie und Unfallchirurgie

23.05.2019 | DAC 2019 | Kongressbericht | Nachrichten

Ist uns „Sichtung“ überhaupt möglich?

22.05.2019 | DAC 2019 | Kongressbericht | Nachrichten

So geht gute Notfallmedizin – so ginge es noch besser

21.05.2019 | DAC 2019 | Kongressbericht | Nachrichten

Cannabis als Medikament?

Mail Icon II Newsletter

Bestellen Sie unseren kostenlosen Newsletter Update Orthopädie und Unfallchirurgie und bleiben Sie gut informiert – ganz bequem per eMail.