TITLE OF
SYNOPSIS
COMPARING PATIENT OUTCOMES OF
ACL REPAIR AND ACL RECONSTRUCTION
A Synopsis Submitted by
WAQAR ELAHI
Registration No: 70129805
BACHELOR OF SCIENCE IN OPERATION THEATER
TECHNOLOGY
SUPERVISOR: Ms. Chandni Robina
Demonstrator at UOL|
Ms scholar in total quality management
Department of HEALTH PROFESSIONAL TECHNOLOGIES
Faculty of Allied Health Sciences
THE UNIVERSITY OF LAHORE
(2021-2025)
INTRODUCTION
Anterior cruciate ligament (ACL) tear is one of the most frequent ligamentous
injuries. A plethora of surgical procedures has been described, from ACL repair to
ACL reconstruction (ACLR) using various grafts. Technical innovation has led to the
advancement in anterior cruciate ligament (ACL) repair in the past decade.
Following ACL rupture, the poor healing potential led to a fall of interest in ACL
repair favoring a gold standard ACL reconstruction. However, ACL Repair has
regained enthusiasm with more recent results showing comparable outcomes to its
reconstructive equivalency with notable advantages such as avoiding donor-site
morbidity while connecting ACL where it is supposed to be in the knee joint.
In an attempt to optimize the biological environment for ACL healing following
repair, a novel bridge-enhanced ACL repair (BEAR) had been developed . It results in
filling the gap between torn ends of the ligament.
On the other hand, ACL reconstruction (ACLR) continues to be associated with
excellent functional results and a high rate of return to sport , but there remains some
concerns regarding donor site morbidity, postoperative muscular weakness, and
development of osteoarthritis
Recent studies have reported varying findings regarding the outcomes of ACL repair
compared with ACL reconstruction, with some studies indicating similar outcomes
and others suggesting better or worse results in terms of mixed objective and patient-
reported outcomes
Objective
To compare the surgical effectiveness, recovery time, functional outcomes, and complication
rates between ACL repair and ACL reconstruction in patients with anterior cruciate
ligament injuries
RATIONALE
This study seeks to clarify the advantages of ACL Repair over traditional ACL
Reconstruction by comparing their impact on recovery outcomes. With different
surgical approaches available, understanding their effects on knee stability, strength,
and return to activity is essential for improving treatment decisions.
LITERATURE REVIEW
Recent advancements in ACL surgery have renewed interest in ACL repair, particularly
Bridge-Enhanced ACL Repair (BEAR), as an alternative to traditional ACL
reconstruction (ACLR). Historically, ACL repair was abandoned due to poor healing
outcomes, but innovations like BEAR—using scaffolds to bridge torn ligament ends—show
promise in restoring native ligament anatomy while reducing donor-site morbidity.
Comparative studies offer mixed results:
Some report similar functional outcomes between BEAR and ACLR.
ACLR remains reliable with high return-to-sport rates, but carries risks of donor
site complications, muscle weakness, and long-term osteoarthritis.
BEAR may allow faster recovery, reduced invasiveness, and better psychological
readiness.
Meta-analyses and randomized controlled trials show no definitive superiority, suggesting
the choice depends on injury type, patient needs, and surgical expertise.
MATERIAL AND METHODS
Study Design:
• This study will employ retrospective Comparative study (Quantitative research)
design to examine the relevant variables at a single point in time.
Duration of Study:
The study will be conducted in 4 months.
Sampling Technique:
A non-probability purposive sampling technique will be employed to select participants
based on specific characteristics or criteria relevant to the research objective
Sample Size
Inclusion Criteria:
• ACL injury confirmed by MRI or arthroscopy
• Age between 16 and 50 years. Active individuals involved in sports or physical
activities.
Exclusion Criteria:
• Previous knee surgeries
• Uncontrolled medical conditions (e.g., diabetes, cardiovascular diseases)
Equipment:
• PROM’s, IKDC Score, Lysholm knee score.
ETHICAL CONSIDERATIONS:
The consent will be taken from the hospitals and patients before using the data.
Patient data will be kept confidential.
The results, whether positive or negative, will be reported transparently, and all
findings will be shared in a way that does not mislead or harm participants or the
scientific community.
DATA COLLECTION PROCEDURE:
A prospective cohort study will compare ACL repair versus ACL reconstruction,
with primary outcomes captured at 6 months post-surgery. This timeframe is
sufficient to detect early complications (e.g. infection, hardware failure), and aligns
with consensus guidance that adverse events often manifest within six months
1. Participant Enrollment & Baseline
Informed consent obtained at pre-operative visit.
Collection of baseline demographic and clinical data: age, sex, injury mechanism,
tear pattern, pre-op PROMs (IKDC, KOOS, Tegner; validated knee-specific tools)
Key contact information (phone, email, next-of-kin) recorded to enable follow-up.
2. Operative Data Collection
Extract from surgical records: procedure type (repair vs reconstruction), graft/fixation
details, intraoperative findings, operative duration, immediate complications
(infection, bleeding, etc.) using a standardized data collection form.
All data collected by trained research staff per registry protocol format.
3. Six-Month Follow-Up Assessment
Schedule in-person evaluations at 6-months post-op, including:
o PROMs (IKDC, KOOS, SF-36, Tegner activity score)
o Clinical tests: Lachman and pivot-shift, range-of-motion, hop tests, KT-1000
if available
o Complication checklist: infection, stiffness, rupture, hardware removal,
contralateral injuries.
If in-person follow-up fails, attempt remote contact up to 3 times via phone, email,
or secure e-PRO system; complete PROMs and self-reports of complications remotely
If still unreachable, extract late complication and outcome data from hospital
electronic or medical records, including admissions, reoperations, or external
treatments documented elsewhere.
5. Follow-Up Completeness & Bias Management
Aim for ≥80% follow-up rate to minimize bias and ensure validity, as strongly
recommended in ACL outcome studies
Log reasons for loss to follow-up; perform sensitivity analysis comparing baseline
characteristics of completed vs incomplete follow-up cases.
6. Data Handling & Quality Assurance
All information entered into a secure electronic data capture (EDC) system or CRF
with double data entry, validation rules (range, completeness, consistency) and audit
trails
Training manual, periodic audits, and oversight ensure uniform data collection across
research personnel
7. Outcome Definitions & Data Integration
Primary outcomes: complication rates (infection, hardware issues, rerupture,
stiffness).
Secondary outcomes: patient-reported outcomes and objective measures.
Integrate data from direct patient contact and record review to compute
complication rates and PROMs by surgical method.
DATA ANALYSIS PROCEDURE:
The collected data will be entered and analyzed using SPSS (Statistical Package for the
Social Sciences) software. Descriptive statistics—including mean, standard deviation,
frequency, and percentage—will be utilized to summarize patient demographics, surgical
technique (ACL Repair vs ACL Reconstruction), and outcome measures (IKDC and Lysholm
scores), along with return-to-sport timing and complications (e.g., infection, rerupture,
stiffness).
To evaluate the relationship between surgical technique and various outcomes, the
Chi-square test will be applied to categorical variables such as graft failure, return-to-sport
status, and the presence of complications. This test will determine whether a statistically
significant association exists between the procedure type and postoperative outcomes.
For continuous variables like IKDC and Lysholm scores, an independent-samples t-test will
be conducted to compare mean scores between the ACL Repair and ACL Reconstruction
groups. This analysis will assess whether the functional outcome differences between the two
surgical methods are statistically significant.
All statistical tests will be interpreted at a significance level of p < 0.05.
Visual representations—including bar graphs, pie charts, and comparative line charts—will
be generated using SPSS to clearly illustrate differences in outcome scores, graft failure rates,
return-to-sport timelines, and complication frequencies between the two groups.
All references and literature sources will be properly cited and organized using EndNote
software to ensure standardized referencing throughout the research documentation.
CONSENT FORM
Title of Study
Comparing the Patient Outcomes of ACL Repair and ACL Reconstruction
Principal Investigator
Waqar Elahi
Student, BS in Operation Theater Technology (BS-OTT)
Contact no. 03090902103
Faculty of Allied Health Sciences
The University of Lahore
1. Description of the Research
You are invited to participate in a research study being conducted by Waqar Elahi, a student of
BS-OTT (Registration No. 70129805) at the University of Lahore. The aim of this research is to
Comparing the Patient Outcomes of ACL Repair and ACL Reconstruction.
2. Risks and Discomforts
This study involves no anticipated risks or discomforts for participants.
3. Potential Benefits
The findings of this study will help in understanding the differences between ACL Repair and
Reconstruction in terms of recovery outcomes, knee stability, return to sport, and complications.
It may assist surgeons and patients in making better-informed treatment decisions.
4. Protection of Confidentiality
All information collected will be kept strictly confidential. Your identity will not be revealed in
any reports, presentations, or publications resulting from this study.
5. Voluntary Participation
Your participation in this study is completely voluntary. You are free to decline participation or
withdraw at any stage without facing any penalty or loss of rights.
6. Consent Statement
By signing below, you confirm that:
You have read and understood this consent form.
You have had the opportunity to ask questions about the study.
You voluntarily agree to take part in this research.
Participant’s Signature: ___________________________
Date: ____________________
رضامندی کا فارم
مطالعے کا عنوان
ACLمرمت اور ACLتعمیر نو کے مریض کے نتائج کا موازنہ کر
تحقیق کنندہ
وقار ا ٰلہی
ط ا ل ب ع ل م ،بی ا یس آ پ ر ی ش ن ت ھ ی ئ ٹ ر ٹ ی کن ا ل و ج ی
نمبر 03090902103رابطہ
فیکلٹی آف ایلائیڈ ہیلتھ سائنسز ،یونیورسٹی آف لاہور
تحقیق کا مقصد اور آپ کی شرکت
طالب علم رجسٹریشن نمبر BS-OTT 70129805آپ کو مطالعے میں شرکت کی دعوت دی جا رہی ہے جس کی رہنمائی کرتے ہیں وقار ا ٰلہی
کی تبدیلی کے نتائج جیسے گھٹنے کی مضبوطی ،بازیابی کی مدت ACL ،کی مرمت اور ACLیونیورسٹی آف لاہور سے۔ اس تحقیق کا مقصد
کمپلیکیشن کی شرح اور کھیل میں واپسی کے لحاظ سے موازنہ کرنا ہے۔
خطرات اور تکالیف
اس مطالعے میں شامل ہونے سے کوئی ممکنہ خطرہ یا تکلیف متوقع نہیں ہے۔
ممکنہ فوائد
کی مرمت اور تبدیلی کے طریقہ کار کے مابین واپسی کی مدت ،مضبوطی ،پیچیدگیوں کی شرح ،اور کھیل میں واپسی جیسے پہلوؤں ACLیہ تحقیق
پر روشنی ڈالے گی ،اور معالجین اور مریضوں کے فیصلوں میں معاون ثابت ہو گی۔
رازداری کا تحفظ
آپ کی فراہم کردہ تمام معلومات سختی سے رازداری کے ساتھ رکھی جائیں گی۔ آپ کی شناخت کسی بھی رپورٹ پریزنٹیشن یا شائع ہونے والے مواد
میں ظاہر نہیں کی جائے گی۔
رضاکارانہ شرکت
آپ کی شرکت بالکل رضاکارانہ ہے۔ آپ کسی بھی وقت اس مطالعے سے انکار یا دستبردار ہو سکتے ہیں بغیر کسی منفی اثر کے۔
رضامندی کا بیان
:مندرجہ ذیل پر دستخط کر کے آپ تصدیق کرتے ہیں کہ
آپ نے اس فارم کو پڑھا اور سمجھا ہے۔
آپ کو سوالات کرنے کا موقع دیا گیا ہے۔
آپ رضاکارانہ طور پر اس مطالعے میں حصہ لینے کی اجازت دیتے ہیں۔
شرکت کنندہ کا نام __________________
شرکت کنندہ کے دستخط ___________________________
تاریخ ____________________
