Anterior Cruciate Ligament (ACL) Reconstruction With Bone Tendon Bone Autograft With Versus Without Internal Bracing

ACL Tear Clinical Trial

Official title:

ACL Reconstruction With Bone Tendon Bone (BTB) Autograft With Versus Without Internal Brace - Clinical and Radiographic Outcomes

Clinical Trial Details — Status: Not yet recruiting

Administrative data

• NCT number: NCT05532189
• Other study ID #: AAAU0966
• Status: Not yet recruiting
• Phase: N/A
• Start date: December 2023
• Est. completion date: September 2032

Study information

• Verified date: August 2023
• Source: Columbia University
• Contact: Christian A Pearsall, BS, BA
• Phone: 251-377-6058
• Email: cap2263[@]cumc.columbia.edu
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

There is no consensus regarding the best surgical management of primary ACL tears. Recent evidence suggests that internal brace augmentation may increase load failure and therefore stabilize the graft in-situ at the time of ACL reconstruction. This prospective randomized controlled trial aims to compare the time to return to activity, and participant reported outcomes in participants with bone-tendon-bone ACL reconstruction with and without (control) internal brace augmentation.

Description:

Despite the wide variety of surgical approaches and grafts that can be used in an ACL reconstruction, graft failure and recurrent knee instability are nevertheless ubiquitous issues that have facilitated interest in ways to strengthen the graft at the time of surgery. While both animal and biomechanical models have strongly suggested improved graft strength and patient outcomes by utilizing suture tape augmentation in ACL reconstructions, there is scant clinical literature available to assess these extrapolations. A retrospective cohort study of 60 patients undergoing ACL reconstruction with a hamstring autograft or allograft (30 suture tape vs 30 no suture tape; mean age: 30), found shorter time to return to activity (9.2 months suture tape group vs 12.9 months no suture tape group; p=0.002), lower Western Ontario and McMaster University Osteoarthritis Indices (WOMAC) (2.2 suture tape group vs 6.2 no suture tape group; p=0.024), higher international knee documentation committee (IKDC) scores (87.6 suture tape group vs 73.2 no suture tape group; p=0.006), lower average pain on the national pain rating scale (NPRS) (0.6 suture tape group vs 1.66 no suture tape group; p=0.021) and no significant difference in range of motion in degrees (129 suture tape group vs 127 no suture tape group; p=0.46), knee injury and osteoarthritis outcome score (KOOS) (92.2 suture tape group vs 87.1 no suture tape group; p=0.68), or complications (13% suture tape vs 10% no suture tape; p>0.05) at 2 years follow up. A retrospective cohort study of 108 patients undergoing ACL reconstruction with a hamstring autograft with and without suture tape reinforcement (36 suture tape vs 72 no suture tape; mean age: 25), found a significantly higher Tegner activity score (7.1 suture tape group vs 6.4 no suture tape group; p=0.026) but otherwise no significant difference in time to preinjury activity level (11.9 mos suture tape group vs 11.6 no suture tape group; p=0.59), range of motion (degrees) (136 suture tape group vs 137 no suture tape group; p=0.44) , Lysholm knee score (95.6 suture tape group vs 94 no suture tape group; p=0.165), IKDC score (94.4 suture tape group vs 93.8 no suture tape group; p=0.44), or complications (6% suture tape group vs 5% no suture tape group; p>0.05) at 2 years follow up. A prospective cohort study of 50 ACL reconstructions with hamstring autograft with and without suture tape reinforcement (25 suture tape group vs 25 no suture tape group; mean age: 30), found a significant improvement in greater than 2 grades of Lachman testing from preoperative assessment compared to 6 months follow-up (68% suture tape group vs 32% no suture tape group; p=0.039) but no difference in Lysholm knee score at 6 months (87.0 suture tape group vs 87.0 no suture tape group; p=0.756). Moreover, none of the already-limited clinical data investigates the use of internal braces with bone-tendon-bone grafts, which are a popular choice for young adults and athletes. Furthermore, there are no current level 1 data on this subject. Therefore, this study aims to compare the time to return to pre- injury activity level, incidence of recurrent knee instability, and patient reported outcomes of patients treated with ACL reconstruction using bone-tendon-bone autograft with and without (control group) internal brace stabilization.

Recruitment information / eligibility

• Status: Not yet recruiting
• Enrollment: 200
• Est. completion date: September 2032
• Est. primary completion date: September 2032
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 12 Years and older

Eligibility

Inclusion Criteria:

• patients 12 and older
• patients seen by the Columbia University Sports Medicine Service
• patients diagnosed with a first time ACL injury by clinical exam and MRI

Exclusion Criteria:

• previous knee surgery
• concurrent knee fracture or ligamentous injury on ipsilateral knee
• neuromuscular disorder involving lower limb
• inability/ unwillingness to adhere to protocol
• anesthesia contraindications
• lost to follow up

Related Conditions & MeSH terms

• ACL Tear
• Anterior Cruciate Ligament Injuries

Intervention

Procedure:
• ACL reconstruction with BTB autograft with internal brace augmentation (suture tape)
The ACL will be reconstructed using a participant's own patella tendon (BTB autograft), and the graft will be fortified by suture tape during the surgery in order to strengthen it.
• ACL reconstruction with BTB autograft without internal brace augmentation (suture tape)
The ACL will be reconstructed using a participant's own patella tendon (BTB autograft). The graft will not be fortified by suture tape in this group. It will be used as is without any modification.

Other:
• Standardized Rehabilitation Protocol
Participants will undergo a standardized rehabilitation protocol with twice weekly physical therapy

Locations

Country	Name	City	State
United States	Columbia University Irving Medical Center	New York	New York

Sponsors (1)

Lead Sponsor	Collaborator
Columbia University

Country where clinical trial is conducted

United States, 

References & Publications (10)

Batty LM, Norsworthy CJ, Lash NJ, Wasiak J, Richmond AK, Feller JA. Synthetic devices for reconstructive surgery of the cruciate ligaments: a systematic review. Arthroscopy. 2015 May;31(5):957-68. doi: 10.1016/j.arthro.2014.11.032. Epub 2015 Jan 22. — View Citation

Bodendorfer BM, Michaelson EM, Shu HT, Apseloff NA, Spratt JD, Nolton EC, Argintar EH. Suture Augmented Versus Standard Anterior Cruciate Ligament Reconstruction: A Matched Comparative Analysis. Arthroscopy. 2019 Jul;35(7):2114-2122. doi: 10.1016/j.arthro.2019.01.054. Epub 2019 Jun 2. — View Citation

Bowman EN, Limpisvasti O, Cole BJ, ElAttrache NS. Anterior Cruciate Ligament Reconstruction Graft Preference Most Dependent on Patient Age: A Survey of United States Surgeons. Arthroscopy. 2021 May;37(5):1559-1566. doi: 10.1016/j.arthro.2021.01.042. Epub 2021 Feb 1. — View Citation

Cohen SB, Yucha DT, Ciccotti MC, Goldstein DT, Ciccotti MA, Ciccotti MG. Factors affecting patient selection of graft type in anterior cruciate ligament reconstruction. Arthroscopy. 2009 Sep;25(9):1006-10. doi: 10.1016/j.arthro.2009.02.010. — View Citation

E A Mackenzie C, Huntington LS, Tulloch S. Suture Tape Augmentation of Anterior Cruciate Ligament Reconstruction Increases Biomechanical Stability: A Scoping Review of Biomechanical, Animal, and Clinical Studies. Arthroscopy. 2022 Jun;38(6):2073-2089. doi: 10.1016/j.arthro.2021.12.036. Epub 2022 Jan 3. — View Citation

Engebretsen L, Benum P, Fasting O, Molster A, Strand T. A prospective, randomized study of three surgical techniques for treatment of acute ruptures of the anterior cruciate ligament. Am J Sports Med. 1990 Nov-Dec;18(6):585-90. doi: 10.1177/036354659001800605. — View Citation

Mall NA, Chalmers PN, Moric M, Tanaka MJ, Cole BJ, Bach BR Jr, Paletta GA Jr. Incidence and trends of anterior cruciate ligament reconstruction in the United States. Am J Sports Med. 2014 Oct;42(10):2363-70. doi: 10.1177/0363546514542796. Epub 2014 Aug 1. — View Citation

Parkes CW, Leland DP, Levy BA, Stuart MJ, Camp CL, Saris DBF, Krych AJ. Hamstring Autograft Anterior Cruciate Ligament Reconstruction Using an All-Inside Technique With and Without Independent Suture Tape Reinforcement. Arthroscopy. 2021 Feb;37(2):609-616. doi: 10.1016/j.arthro.2020.09.002. Epub 2020 Nov 2. — View Citation

Smith PA, Bley JA. Allograft Anterior Cruciate Ligament Reconstruction Utilizing Internal Brace Augmentation. Arthrosc Tech. 2016 Oct 10;5(5):e1143-e1147. doi: 10.1016/j.eats.2016.06.007. eCollection 2016 Oct. — View Citation

Spindler KP, Wright RW. Clinical practice. Anterior cruciate ligament tear. N Engl J Med. 2008 Nov 13;359(20):2135-42. doi: 10.1056/NEJMcp0804745. No abstract available. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Time to Return to Full Activity or Sports	Time from treatment initiation to full return to pre-injury activity levels in each group, expressed in weeks	Measured once per participant, depending on the time required to return to full activity (up to 10 years)
Primary	Percentage of Participants with Recurrent Knee Instability	Percentage of participants that experience recurrent instability after treatment starts at each time point	2 weeks, 6 weeks, 3 months, 6 months, 1 year, 2 years, 5 years and 10 years
Primary	Change in Patient Reported Outcome Measurement Information System (PROMIS) Physical Function (PF) Computer Adaptive Test (CAT) at 2 weeks	A computerized questionnaire ranging from 0 to 100 points that addresses how a participant's physical functional capacity has been impacted by their knee injury. A lower score indicates a better outcome.	Baseline and 2 weeks
Primary	Change in PROMIS PF CAT at 6 weeks	A computerized questionnaire ranging from 0 to 100 points that addresses how a participant's physical functional capacity has been impacted by their knee injury. A lower score indicates a better outcome.	Baseline and 6 weeks
Primary	Change in PROMIS PF CAT at 3 months	A computerized questionnaire ranging from 0 to 100 points that addresses how a participant's physical functional capacity has been impacted by their knee injury. A lower score indicates a better outcome.	Baseline and 3 months
Primary	Change in PROMIS PF CAT at 6 months	A computerized questionnaire ranging from 0 to 100 points that addresses how a participant's physical functional capacity has been impacted by their knee injury. A lower score indicates a better outcome.	Baseline and 6 months
Primary	Change in PROMIS PF CAT at 1 year	A computerized questionnaire ranging from 0 to 100 points that addresses how a participant's physical functional capacity has been impacted by their knee injury. A lower score indicates a better outcome.	Baseline and 1 year
Primary	Change in PROMIS PF CAT at 2 years	A computerized questionnaire ranging from 0 to 100 points that addresses how a participant's physical functional capacity has been impacted by their knee injury. A lower score indicates a better outcome.	Baseline and 2 years
Primary	Change in PROMIS PF CAT at 5 years	A computerized questionnaire ranging from 0 to 100 points that addresses how a participant's physical functional capacity has been impacted by their knee injury. A lower score indicates a better outcome.	Baseline and 5 years
Primary	Change in PROMIS PF CAT at 10 years	A computerized questionnaire ranging from 0 to 100 points that addresses how a participant's physical functional capacity has been impacted by their knee injury. A lower score indicates a better outcome.	Baseline and 10 years
Primary	Change in PROMIS Pain Interference (PI) CAT at 2 weeks	A computerized questionnaire ranging from 0 to 100 points that addresses how a participant's pain has been impacted by their knee injury. A lower score indicates a better outcome.	Baseline and 2 weeks
Primary	Change in PROMIS PI CAT at 6 weeks	A computerized questionnaire ranging from 0 to 100 points that addresses how a participant's pain has been impacted by their knee injury. A lower score indicates a better outcome.	Baseline and 6 weeks
Primary	Change in PROMIS PI CAT at 3 months	A computerized questionnaire ranging from 0 to 100 points that addresses how a participant's pain has been impacted by their knee injury. A lower score indicates a better outcome.	Baseline and 3 months
Primary	Change in PROMIS PI CAT at 6 months	A computerized questionnaire ranging from 0 to 100 points that addresses how a participant's pain has been impacted by their knee injury. A lower score indicates a better outcome.	Baseline and 6 months
Primary	Change in PROMIS PI CAT at 1 year	A computerized questionnaire ranging from 0 to 100 points that addresses how a participant's pain has been impacted by their knee injury. A lower score indicates a better outcome.	Baseline and 1 year
Primary	Change in PROMIS PI CAT at 2 years	A computerized questionnaire ranging from 0 to 100 points that addresses how a participant's pain has been impacted by their knee injury. A lower score indicates a better outcome.	Baseline and 2 years
Primary	Change in PROMIS PI CAT at 5 years	A computerized questionnaire ranging from 0 to 100 points that addresses how a participant's pain has been impacted by their knee injury. A lower score indicates a better outcome.	Baseline and 5 years
Primary	Change in PROMIS PI CAT at 10 years	A computerized questionnaire ranging from 0 to 100 points that addresses how a participant's pain has been impacted by their knee injury. A lower score indicates a better outcome.	Baseline and 10 years
Primary	Change in PROMIS Depression CAT at 2 weeks	A computerized questionnaire ranging from 0 to 100 points that addresses how a participant's quality of life has been impacted by their knee injury. A lower score indicates a better outcome.	Baseline and 2 weeks
Primary	Change in PROMIS Depression CAT at 6 weeks	A computerized questionnaire ranging from 0 to 100 points that addresses how a participant's quality of life has been impacted by their knee injury. A lower score indicates a better outcome.	Baseline and 6 weeks
Primary	Change in PROMIS Depression CAT at 3 months	A computerized questionnaire ranging from 0 to 100 points that addresses how a participant's quality of life has been impacted by their knee injury. A lower score indicates a better outcome.	Baseline and 3 months
Primary	Change in PROMIS Depression CAT at 6 months	A computerized questionnaire ranging from 0 to 100 points that addresses how a participant's quality of life has been impacted by their knee injury. A lower score indicates a better outcome.	Baseline and 6 months
Primary	Change in PROMIS Depression CAT at 1 year	A computerized questionnaire ranging from 0 to 100 points that addresses how a participant's quality of life has been impacted by their knee injury. A lower score indicates a better outcome.	Baseline and 1 year
Primary	Change in PROMIS Depression CAT at 2 years	A computerized questionnaire ranging from 0 to 100 points that addresses how a participant's quality of life has been impacted by their knee injury. A lower score indicates a better outcome.	Baseline and 2 years
Primary	Change in PROMIS Depression CAT at 5 years	A computerized questionnaire ranging from 0 to 100 points that addresses how a participant's quality of life has been impacted by their knee injury. A lower score indicates a better outcome.	Baseline and 5 years
Primary	Change in PROMIS Depression CAT at 10 years	A computerized questionnaire ranging from 0 to 100 points that addresses how a participant's quality of life has been impacted by their knee injury. A lower score indicates a better outcome.	Baseline and 10 years
Secondary	Change in Western Ontario and McMaster Universities Arthritis Index (WOMAC) Score at 2 weeks	The WOMAC questionnaire has subscores for pain (0-20), stiffness (0-8), and physical function (0-68), which address the impact of an injury on a participant's life. A lower total score (sum of subscores) indicates a better outcome.	Baseline and 2 weeks
Secondary	Change in Western Ontario and McMaster Universities Arthritis Index (WOMAC) Score at 6 weeks	The WOMAC questionnaire has subscores for pain (0-20), stiffness (0-8), and physical function (0-68), which address the impact of an injury on a participant's life. A lower total score (sum of subscores) indicates a better outcome.	Baseline and 6 weeks
Secondary	Change in Western Ontario and McMaster Universities Arthritis Index (WOMAC) Score at 3 months	The WOMAC questionnaire has subscores for pain (0-20), stiffness (0-8), and physical function (0-68), which address the impact of an injury on a participant's life. A lower total score (sum of subscores) indicates a better outcome.	Baseline and 3 months
Secondary	Change in Western Ontario and McMaster Universities Arthritis Index (WOMAC) Score at 6 months	The WOMAC questionnaire has subscores for pain (0-20), stiffness (0-8), and physical function (0-68), which address the impact of an injury on a participant's life. A lower total score (sum of subscores) indicates a better outcome.	Baseline and 6 months
Secondary	Change in Western Ontario and McMaster Universities Arthritis Index (WOMAC) Score at 1 year	The WOMAC questionnaire has subscores for pain (0-20), stiffness (0-8), and physical function (0-68), which address the impact of an injury on a participant's life. A lower total score (sum of subscores) indicates a better outcome.	Baseline and 1 year
Secondary	Change in Western Ontario and McMaster Universities Arthritis Index (WOMAC) Score at 2 years	The WOMAC questionnaire has subscores for pain (0-20), stiffness (0-8), and physical function (0-68), which address the impact of an injury on a participant's life. A lower total score (sum of subscores) indicates a better outcome.	Baseline and 2 years
Secondary	Change in Western Ontario and McMaster Universities Arthritis Index (WOMAC) Score at 5 years	The WOMAC questionnaire has subscores for pain (0-20), stiffness (0-8), and physical function (0-68), which address the impact of an injury on a participant's life. A lower total score (sum of subscores) indicates a better outcome.	Baseline and 5 years
Secondary	Change in Western Ontario and McMaster Universities Arthritis Index (WOMAC) Score at 10 years	The WOMAC questionnaire has subscores for pain (0-20), stiffness (0-8), and physical function (0-68), which address the impact of an injury on a participant's life. A lower total score (sum of subscores) indicates a better outcome.	Baseline and 10 years
Secondary	Change in International Knee Documentation Committee (IKDC) Score at 2 weeks	The IKDC questionnaire is scored from 0 (worse outcome)-100 (better outcome) and addresses knee symptoms, function, and physical activity.	Baseline and 2 weeks
Secondary	Change in International Knee Documentation Committee (IKDC) Score at 6 weeks	The IKDC questionnaire is scored from 0 (worse outcome)-100 (better outcome) and addresses knee symptoms, function, and physical activity.	Baseline and 6 weeks
Secondary	Change in International Knee Documentation Committee (IKDC) Score at 3 months	The IKDC questionnaire is scored from 0 (worse outcome)-100 (better outcome) and addresses knee symptoms, function, and physical activity.	Baseline and 3 months
Secondary	Change in International Knee Documentation Committee (IKDC) Score at 6 months	The IKDC questionnaire is scored from 0 (worse outcome)-100 (better outcome) and addresses knee symptoms, function, and physical activity.	Baseline and 6 months
Secondary	Change in International Knee Documentation Committee (IKDC) Score at 1 year	The IKDC questionnaire is scored from 0 (worse outcome)-100 (better outcome) and addresses knee symptoms, function, and physical activity.	Baseline and 1 year
Secondary	Change in International Knee Documentation Committee (IKDC) Score at 2 years	The IKDC questionnaire is scored from 0 (worse outcome)-100 (better outcome) and addresses knee symptoms, function, and physical activity.	Baseline and 2 years
Secondary	Change in International Knee Documentation Committee (IKDC) Score at 5 years	The IKDC questionnaire is scored from 0 (worse outcome)-100 (better outcome) and addresses knee symptoms, function, and physical activity.	Baseline and 5 years
Secondary	Change in International Knee Documentation Committee (IKDC) Score at 10 years	The IKDC questionnaire is scored from 0 (worse outcome)-100 (better outcome) and addresses knee symptoms, function, and physical activity.	Baseline and 10 years
Secondary	Change in numeric pain rating scale (NPRS) Score at 2 weeks	The NPRS is a questionnaire on a visual analog scale of 0 to 10 that a participant rates based on how bad their pain is (0 = no pain; 10 = maximum pain)	Baseline and 2 weeks
Secondary	Change in numeric pain rating scale (NPRS) Score at 6 weeks	The NPRS is a questionnaire on a visual analog scale of 0 to 10 that a participant rates based on how bad their pain is (0 = no pain; 10 = maximum pain)	Baseline and 6 weeks
Secondary	Change in numeric pain rating scale (NPRS) Score at 3 months	The NPRS is a questionnaire on a visual analog scale of 0 to 10 that a participant rates based on how bad their pain is (0 = no pain; 10 = maximum pain)	Baseline and 3 months
Secondary	Change in numeric pain rating scale (NPRS) Score at 6 months	The NPRS is a questionnaire on a visual analog scale of 0 to 10 that a participant rates based on how bad their pain is (0 = no pain; 10 = maximum pain)	Baseline and 6 months
Secondary	Change in numeric pain rating scale (NPRS) Score at 1 year	The NPRS is a questionnaire on a visual analog scale of 0 to 10 that a participant rates based on how bad their pain is (0 = no pain; 10 = maximum pain)	Baseline and 1 year
Secondary	Change in numeric pain rating scale (NPRS) Score at 2 years	The NPRS is a questionnaire on a visual analog scale of 0 to 10 that a participant rates based on how bad their pain is (0 = no pain; 10 = maximum pain)	Baseline and 2 years
Secondary	Change in numeric pain rating scale (NPRS) Score at 5 years	The NPRS is a questionnaire on a visual analog scale of 0 to 10 that a participant rates based on how bad their pain is (0 = no pain; 10 = maximum pain)	Baseline and 5 years
Secondary	Change in numeric pain rating scale (NPRS) Score at 10 years	The NPRS is a questionnaire on a visual analog scale of 0 to 10 that a participant rates based on how bad their pain is (0 = no pain; 10 = maximum pain)	Baseline and 10 years
Secondary	Change in Knee Injury and Osteoarthritis Outcome Score (KOOS) at 2 weeks	The KOOS score is a questionnaire regarding the severity of participants' knee symptoms, which is scored from 0 to 100 (100 representing no severity; 0 representing maximum severity )	Baseline and 2 weeks
Secondary	Change in Knee Injury and Osteoarthritis Outcome Score (KOOS) at 6 weeks	The KOOS score is a questionnaire regarding the severity of participants' knee symptoms, which is scored from 0 to 100 (100 representing no severity; 0 representing maximum severity )	Baseline and 6 weeks
Secondary	Change in Knee Injury and Osteoarthritis Outcome Score (KOOS) at 3 months	The KOOS score is a questionnaire regarding the severity of participants' knee symptoms, which is scored from 0 to 100 (100 representing no severity; 0 representing maximum severity )	Baseline and 3 months
Secondary	Change in Knee Injury and Osteoarthritis Outcome Score (KOOS) at 6 months	The KOOS score is a questionnaire regarding the severity of participants' knee symptoms, which is scored from 0 to 100 (100 representing no severity; 0 representing maximum severity )	Baseline and 6 months
Secondary	Change in Knee Injury and Osteoarthritis Outcome Score (KOOS) at 1 year	The KOOS score is a questionnaire regarding the severity of participants' knee symptoms, which is scored from 0 to 100 (100 representing no severity; 0 representing maximum severity )	Baseline and 1 year
Secondary	Change in Knee Injury and Osteoarthritis Outcome Score (KOOS) at 2 years	The KOOS score is a questionnaire regarding the severity of participants' knee symptoms, which is scored from 0 to 100 (100 representing no severity; 0 representing maximum severity )	Baseline and 2 years
Secondary	Change in Knee Injury and Osteoarthritis Outcome Score (KOOS) at 5 years	The KOOS score is a questionnaire regarding the severity of participants' knee symptoms, which is scored from 0 to 100 (100 representing no severity; 0 representing maximum severity )	Baseline and 5 years
Secondary	Change in Knee Injury and Osteoarthritis Outcome Score (KOOS) at 10 years	The KOOS score is a questionnaire regarding the severity of participants' knee symptoms, which is scored from 0 to 100 (100 representing no severity; 0 representing maximum severity )	Baseline and 10 years
Secondary	Change in Tegner activity scale (TAS) Score at 2 weeks	TAS is a one-item questionnaire assessing the activity level of patients on a scale of 0-10, with 0 representing disability and 10 representing the level of a professional athlete.	Baseline and 2 weeks
Secondary	Change in Tegner activity scale (TAS) Score at 6 weeks	TAS is a one-item questionnaire assessing the activity level of patients on a scale of 0-10, with 0 representing disability and 10 representing the level of a professional athlete.	Baseline and 6 weeks
Secondary	Change in Tegner activity scale (TAS) Score at 3 months	TAS is a one-item questionnaire assessing the activity level of patients on a scale of 0-10, with 0 representing disability and 10 representing the level of a professional athlete.	Baseline and 3 months
Secondary	Change in Tegner activity scale (TAS) Score at 6 months	TAS is a one-item questionnaire assessing the activity level of patients on a scale of 0-10, with 0 representing disability and 10 representing the level of a professional athlete.	Baseline and 6 months
Secondary	Change in Tegner activity scale (TAS) Score at 1 year	TAS is a one-item questionnaire assessing the activity level of patients on a scale of 0-10, with 0 representing disability and 10 representing the level of a professional athlete.	Baseline and 1 year
Secondary	Change in Tegner activity scale (TAS) Score at 2 years	TAS is a one-item questionnaire assessing the activity level of patients on a scale of 0-10, with 0 representing disability and 10 representing the level of a professional athlete.	Baseline and 2 years
Secondary	Change in Tegner activity scale (TAS) Score at 5 years	TAS is a one-item questionnaire assessing the activity level of patients on a scale of 0-10, with 0 representing disability and 10 representing the level of a professional athlete.	Baseline and 5 years
Secondary	Change in Tegner activity scale (TAS) Score at 10 years	TAS is a one-item questionnaire assessing the activity level of patients on a scale of 0-10, with 0 representing disability and 10 representing the level of a professional athlete.	Baseline and 10 years
Secondary	Change in Lysholm Score at 2 weeks	Lysholm score is a questionnaire out of 100 points that addresses specific aspects of participant's knee symptoms, with 100 indicating little to no symptoms and 0 indicating severe symptoms.	Baseline and 2 weeks
Secondary	Change in Lysholm Score at 6 weeks	Lysholm score is a questionnaire out of 100 points that addresses specific aspects of participant's knee symptoms, with 100 indicating little to no symptoms and 0 indicating severe symptoms.	Baseline and 6 weeks
Secondary	Change in Lysholm Score at 3 months	Lysholm score is a questionnaire out of 100 points that addresses specific aspects of participant's knee symptoms, with 100 indicating little to no symptoms and 0 indicating severe symptoms.	Baseline and 3 months
Secondary	Change in Lysholm Score at 6 months	Lysholm score is a questionnaire out of 100 points that addresses specific aspects of participant's knee symptoms, with 100 indicating little to no symptoms and 0 indicating severe symptoms.	Baseline and 6 months
Secondary	Change in Lysholm Score at 1 year	Lysholm score is a questionnaire out of 100 points that addresses specific aspects of participant's knee symptoms, with 100 indicating little to no symptoms and 0 indicating severe symptoms.	Baseline and 1 year
Secondary	Change in Lysholm Score at 2 years	Lysholm score is a questionnaire out of 100 points that addresses specific aspects of participant's knee symptoms, with 100 indicating little to no symptoms and 0 indicating severe symptoms.	Baseline and 2 years
Secondary	Change in Lysholm Score at 5 years	Lysholm score is a questionnaire out of 100 points that addresses specific aspects of participant's knee symptoms, with 100 indicating little to no symptoms and 0 indicating severe symptoms.	Baseline and 5 years
Secondary	Change in Lysholm Score at 10 years	Lysholm score is a questionnaire out of 100 points that addresses specific aspects of participant's knee symptoms, with 100 indicating little to no symptoms and 0 indicating severe symptoms.	Baseline and 10 years