2025 ISAKOS Biennial Congress ePoster
Augmentation Of Hamstring Graft With Fiber tape : A Ray Of Hope To Reduce Graft Retear Rate ,Post Op Laxity and better Functional Outcome In ACL Reconstruction.
Saurabh Singh, MS(ORTHO) , MCh, Varanasi, Uttar Pradesh INDIA
Dr Sushit Kumar Sonu, MBBS INDIA
Kumar Prashant INDIA
Rahul Patel, MS (ORTHOPEDICS), Varanasi, Uttar Pradesh INDIA
Himanshu Chaudhary, MBBS, MS, VARANASI, Uttar Pradesh INDIA
Himanshu Kumar Nagar, MBBS, VARANASI, Uttar Pradesh INDIA
INSTITUTE OF MEDICAL SCIENCES , BHU, VARANASI, Uttar Pradesh, INDIA
FDA Status Cleared
Summary
Augmentation of Hamstring graft with UHMW polyesters like fiber tape gives better results than conventional ACL reconstruction.
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Abstract
Introduction-ACL is the most important translational and rotational stabilizer of the knee joint. Among knee injuries, ACL is the most common ligament to be injured in athletes. ACL injury management may vary from conservative management to surgical management comprising of its repair or reconstruction using an allograft or an autograft. The major complication with these management strategies is the graft retear or failure. Internal bracing is
Method
of augmentation of the graft during reconstruction and of native ACL in cases of repair. Internal brace acts as a stress shielding structure for the graft, stabilizes the knee joint till ACL graft heals allowing the ligamentization process to progress at the same time. This reduces the postop rehabilitation time and decreases re-tear rate of graft.
Aims and objectives-Our study aimed to compare the functional and radiological outcomes of ACL reconstruction with hamstring tendon graft augmented with internal brace fiber tape versus conventional ACL reconstruction using hamstring tendon alone.
Methodology-A prospective cohort study was carried out. Patients with complete ACL tear fitting into the inclusion criteria were selected and were divided into 2 cohorts based on graft thickness. Graft thickness equal to or less than 8 mm were put under ACLF And those with more than 8mm were put under ACLC group. Both the groups underwent Arthroscopic ACL reconstruction, a common rehabilitation protocol and were followed up at 3,6,9and12months post-surgery and data were collected.
Results-Patients undergoing ACL reconstruction with augmentation had better stability, less postop laxity, less quadriceps atrophy and better functional scores at 6 months and 1year postop compared to the patients in the group who underwent ACL reconstruction without augmentation. MRI at 1 year follow-up showed less joint effusion, less edema at the graft origin and insertion site and less buckling of PCL in augmentation group .There were 2 report of graft retear within 1 year of postop in a patient who underwent ACL reconstruction without augmentation while no such complication was observed in augmentation group.
Conclusion
– ACL reconstruction with Internal bracing reduces post op laxity increases stability has better functional and radiological outcomes than conventional ACL reconstruction. Hence internal bracing can be considered for better results especially in patients with a thin graft and more research with a larger sample size for a longer period of time needs to be done to look for long term effects.