Summary: An internal brace used in an ACL graft construct does not impair graft healing at 12 months on MRI and shows no difference in PROMs or KT-1000 measurements when compared to a matched ACL cohort without an internal brace

Background

The addition of an internal brace to the graft construct in ACL reconstruction is a recently evolving surgical technique, with the hope of reducing reinjury and improving outcomes. To date there is limited literature on this technique, particularly examining the effect this addition may have on graft healing or clinical outcomes.

Objective

To determine the influence of an internal brace on the healing of a primary single bundle ACL graft at 1-year

Methods

A case-matched series was used to compare graft healing, as assessed by high resolution MRI scan at 12 months, in 2 cohorts of ACL reconstruction patients. A single surgeon case series of 68 patients who underwent hamstring ACL reconstruction with bipolar suspensory fixation and the addition of an internal brace to the construct were compared against an age and sex matched cohort of ACL reconstructions from the same surgeon using the identical technique but without the internal brace. MRI scans at one-year post-operatively were analysed using a previously validated protocol to assess the graft signal/noise quotient (SNQ) across three sites of the graft, as a measure of graft healing after primary single-bundle ACL reconstruction

Results

There was no effect of age or gender on SNQ (p>0.05). The SNQ values in the internal brace group were distally 2.1 ± 2.6, midsubstance 4.1 ± 3.7, proximally 3.3 ± 2.9, with a mean SNQ of 3.2 ± 2.6. The SNQ values in the cohort without the internal brace was distally 2.1 ± 1.9, in the midsubstance 3.1 ± 2.0, proximally 2.3 ± 1.4, with an overall mean of 2.5 ±1.5. There was no significant difference (p>0.05) in SNQ between the ACL reconstruction group using internal brace and the group without the use of an internal brace at any of the 3 measurement areas or between the means, although the p value in the proximal measurement approached significance at 0.051. There was no significant difference between Tegner, IKDC and Lysholm scores recorded at 12 months between the cohorts. KT-1000 measurements at 134N also showed no significant difference between the cohorts.

Conclusion

The use of an internal brace in a single-bundle hamstring ACL reconstruction does not appear to affect graft healing, as assessed by MRI scan at 1 year.

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Comparative Study Of “Concomitant Patellar Tendon Rupture With Anterior cruciate ligament tear and Patellar Tendon Rupture With Multi- Ligamentous Knee Injury –MLKI” Abstract Presentation 6 minutes Silvampatti Ramasamy Sundararajan, MS(Orth), INDIA Rajagopalakrishnan Ramakanth, D.ortho, DNB(ortho), D.SICOT, INDIA S Rajasekaran, MS(Orth),DOrth,DNB,FRCS(Ed),FRCS(Lon),MCh(Liv),PhD, INDIA
Acl Deficiency Influences Medio-Lateral Tibial Alignment And Knee Varus–Valgus During In Vivo Activities Abstract Presentation 3 minutes Piero Agostinone, MD, ITALY Stefano Di Paolo, Eng, PhD, ITALY Alberto Grassi, PhD, ITALY Marco Bontempi, PhD, ITALY Erika Pinelli, MsC, ITALY Laura Bragonzoni, Prof., ITALY Stefano Zaffagnini, MD, Prof., ITALY
Does In Vivo Kinematics Following Acl Reconstruction With Or Without Lateral Extraarticular Tenodesis Correlate With Preoperative Quantitative Pivot Shift? Abstract Presentation 5 minutes Christopher M. Gibbs, MD, UNITED STATES Philipp Wilhelm Winkler, MD, Assoc. Prof., AUSTRIA Jonathan D Hughes, MD, PhD, UNITED STATES Adam J. Popchak, DPT, PhD, UNITED STATES Daisuke Chiba, MD, PhD, JAPAN Bryson P. Lesniak, MD, UNITED STATES William Anderst, PhD, UNITED STATES Volker Musahl, MD, Prof., UNITED STATES
Higher Return To Pre-Injury Activity Levels Following ACL Reconstruction With Bone-Patellar Tendon-Bone Versus Hamstring Tendon Autograft In High Activity Patients: Results From The New Zealand ACL Registry Abstract Presentation 6 minutes Simon W. Young, MD, FRACS, NEW ZEALAND Richard Rahardja, MBChB, BMedSc(Hons), NEW ZEALAND Mark G. Clatworthy, FRACS, NEW ZEALAND Paul Monk, DPhil (Oxon), FRCS, NEW ZEALAND Hamish Love, FRACS, NEW ZEALAND
Quadriceps Tendon Autograft Has Lower MRI Signal Than Hamstring Tendon Autograft In Anterior Cruciate Ligament Reconstructions Of Adolescent Athletes Abstract Presentation 5 minutes David Alcoloumbre, MD, UNITED STATES Alexandra Hunter Aitchison, UNITED STATES Douglas Mintz, MD, UNITED STATES Frank A. Cordasco, MD, MS, UNITED STATES Daniel W. Green, MD, MS, UNITED STATES
Acl - Pcl Fixation Sequence During Multi-Ligament Knee Reconstruction Does Not Affect Knee Laxity Abstract Presentation 6 minutes Carola F. van Eck, MD, PhD, FAAOS, UNITED STATES Aly Maher Fayed, MD, EGYPT Ryo Kanto, MD, JAPAN Taylor M. Price, MS, UNITED STATES Michael Dinenna, BS, UNITED STATES Monica A. Linde, MSIE, RN, UNITED STATES Patrick J. Smolinski, PhD, UNITED STATES
Return To Sports After Paediatric Anterior Cruciate Ligament Reconstruction (ACLR): Normal Population Vs An ACLR Cohort Abstract Presentation 6 minutes Alexander S. Nicholls, MSc, FRACS, AUSTRALIA Jillian Lee, BHB, MBChB, FRACS (Ortho), NEW ZEALAND Yoong Lim, BEng, PhD, AUSTRALIA Quang Dao, FRACS, AUSTRALIA
Dynamic Radiostereometry Evaluation Of Two Different Anterior Cruciate Ligament Reconstruction Techniques: Does Single Bundle Reconstruction Plus Lateral Plasty Cause Knee Over-Constraint? Abstract Presentation 4 minutes Alberto Grassi, PhD, ITALY Stefano Di Paolo, Eng, PhD, ITALY Piero Agostinone, MD, QATAR Gian Andrea Lucidi, MD, ITALY Erika Pinelly, MsC, ITALY Marco Bontempi, PhD, ITALY Laura Bragonzoni, Prof., ITALY Stefano Zaffagnini, MD, Prof., ITALY

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The Use Of An Internal Brace In A Single Bundle Hamstring Graft And Its Effect On Graft Healing At 1 Year After Anterior Cruciate Ligament Reconstruction

The Use Of An Internal Brace In A Single Bundle Hamstring Graft And Its Effect On Graft Healing At 1 Year After Anterior Cruciate Ligament Reconstruction

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The Use Of An Internal Brace In A Single Bundle Hamstring Graft And Its Effect On Graft Healing At 1 Year After Anterior Cruciate Ligament Reconstruction

The Use Of An Internal Brace In A Single Bundle Hamstring Graft And Its Effect On Graft Healing At 1 Year After Anterior Cruciate Ligament Reconstruction

Background

Objective

Methods

Results

Conclusion

More ISAKOS 2021: Global Content