Summary

The study concludes that hamstring autograft with internal bracing offers superior self-reported outcomes and knee stability compared to autograft alone, emphasizing the need for optimized surgical techniques to enhance patient outcomes and improve postoperative quality of life.

Abstract

Anterior cruciate ligament (ACL) is the most injured knee ligament. The gold standard for management of acute ruptures of ACL is surgical treatment with ACL reconstruction (ACLR) using tendon or ligament autograft. Background. Internal brace augmented ACL reconstruction is a technique that marries a previously published technique with the potential advantages of suture tape augmentation to increase the biomechanical strength of the reconstruction at the time of surgery and potentially reinforcing the graft thereafter. Methods. Patients were randomly assigned into an experimental group or a control group. A total 67 patients were included in the study 36 patient underwent ACLR with hamstring tendon autograft and 31 patients underwent ACLR with internal bracing. Self-reported outcomes were measured using IKDC, Tegner- Lysholm and KOOS at 1 month, 4 months, 8 months and 1 year post-operatively. Joint laxity was assessed post-operatively at 4 months, 8 months and 1 year Results. IKDC scores revealed significant differences (p < .001) between the two surgical techniques at all time points. Tegner-Lysholm scores by the one-year mark showed continued improvement on both groups. The control group mean score was 95.7 (median 97), whereas the intervention group exhibited enhancement with a mean score of 98.5 (median 100). The intervention group recorded a mean KOOS score of 67.8 (median 69), indicating comparatively better early functional recovery and knee-related quality of life than the control group's mean score of 53.9 (median 52). The consistent negativity of the pivot shift test results in both groups suggests that most patients maintained a stable knee joint post-surgery, regardless of whether they received the intervention or not. Conclusion. The study concludes that hamstring autograft with internal bracing offers superior self-reported outcomes and knee stability compared to autograft alone, emphasizing the need for optimized surgical techniques to enhance patient outcomes and improve postoperative quality of life.