Patient‐reported outcomes after anterior cruciate ligament reconstruction with the JewelACL synthetic ligament: Multicenter study of at least 9 years follow‐up
Klaudiusz Kosowski, Ewa Bręborowicz, Marek Olek, Maciej WiśniewskiAbstract
Purpose
Synthetic grafts for anterior cruciate ligament (ACL) reconstruction aim to address limitations of biological grafts, such as donor‐site morbidity and delayed recovery. JewelACL is a synthetic scaffold developed to enhance biological integration and mechanical durability. This multicenter study evaluated long‐term patient‐reported outcomes, adverse events, re‐rupture rates and return‐to‐sport outcomes following ACL reconstruction using JewelACL, with a minimum follow‐up of 9 years.
Methods
A retrospective cohort of 58 patients who underwent ACL reconstruction between 2010 and 2014, using either JewelACL alone ( n = 44) or JewelACL combined with hamstring autograft (hybrid technique; n = 14), was assessed. Patient‐reported outcome measures (PROMs), including the International Knee Documentation Committee (IKDC), Lysholm and Tegner scores, as well as complication and re‐rupture rates, were analysed. Long‐term follow‐up was based on telephone‐administered PROMs; no standardised clinical laxity testing or imaging (magnetic resonance imaging or x‐ray) was performed.
Results
At a mean follow‐up of 10.8 ± 0.9 years, the re‐rupture rate was (5.2%) 3 cases out of 58. Median Lysholm and IKDC scores were 100 (interquartile range [IQR] 91–100) and 95 (IQR 89–99), respectively, indicating excellent long‐term knee function. The mean Tegner score at follow‐up was 5.2 ± 1.7, representing a modest decline from the pre‐injury level of 6.5, consistent with age‐related reductions in activity. No patient‐reported infections or hospital admissions related to the operated knee were reported. IKDC scores were significantly higher in the JewelACL‐only group than in the hybrid group ( p = 0.02), while Lysholm and Tegner scores did not differ significantly.
Conclusions
ACL reconstruction using JewelACL was associated with excellent long‐term PROMs, low re‐rupture rates and high return‐to‐sport rates. Although these findings are encouraging, interpretation is limited by the retrospective design, substantial loss to follow‐up and the absence of imaging or objective clinical assessments. There was no statistically significant difference in return‐to‐sport rates between the JewelACL group (85%) and the hybrid group (86%) ( p = 1.00).
Level of Evidence
Level IV.