Suture Tape Augmentation of Posterior Cruciate Ligament Reconstruction Shows Improved Biomechanical Stability With Equivalent Outcome and Complication Rates: A Scoping Review.

Abstract

To assess the current literature surrounding suture tape augmentation (STA) of posterior cruciate ligament reconstruction (PCLR) with additional evaluation of PCLR+STA in clinical practice. A systematic search of 3 databases (PubMed, EMBASE, and Web of Science Core Collection) was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was completed in April 2023 to identify studies related to PCLR+STA. Surgical technique, animal, biomechanical, and clinical studies were included for review with quality appraisal conducted according to study design. A total of 380 articles were identified in the search, 6 of which met inclusion criteria. Biomechanical studies showed a significant reduction in posterior tibial translation with STA of PCLR in multiple studies. STA was found to decrease total elongation by 45% to 58% in multiple studies; increased load to failure was seen with STA as well in 1 study. Clinical studies showed equivalent or improved patient-reported outcomes with STA of PCLR compared with PCLR alone. Biomechanical studies offer evidence showing the beneficial load-sharing properties of STA such as increased strength and ultimate load with decreased elongation of the graft, especially with larger forces. Clinical evidence illustrates improved or equivalent patient-reported outcomes to standard PCLR with no difference in complication rate. STA of PCLR offers an opportunity to improve initial graft stability during the early healing phase through load sharing between the augmentation and the graft.