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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Posterior Tibial Plateau Impaction Fractures Are Not Associated With Increased Knee Instability: A Quantitative Pivot Shift Analysis Abstract Presentation 8 minutes Brian M Godshaw, MD, UNITED STATES Joshua C Setliff, BA, UNITED STATES Jonathan D Hughes, MD, PhD, UNITED STATES Volker Musahl, MD, Prof., UNITED STATES
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
Sex Related Outcomes Following Anterior Cruciate Ligament Reconstruction (Aclr): A Systematic Review and Meta-Analysis Abstract Presentation 5 minutes Anthony Charles Mok, BS, UNITED STATES Andrew J Fancher, BS, UNITED STATES Matthew L Vopat, MD, UNITED STATES Jordan Charles Baker, BS, UNITED STATES Armin Tarakemeh, BS, UNITED STATES Mary K. Mulcahey, MD, UNITED STATES Scott Mullen, MD, UNITED STATES Paul Schroeppel, MD, UNITED STATES Kimberly J. Templeton, MD, UNITED STATES Bryan Vopat, UNITED STATES
Outcomes Following Anterior Cruciate Ligament Reconstruction in Young Patients: An Observational Study. ePoster Presentation Kunal Mohan, MB MCh MRCSI, IRELAND David Cooper, MB MRCSI, IRELAND Niall McGoldrick, MB MCh FRCS (Tr & Orth), IRELAND Martin Davey, MB MCh MRCSI, IRELAND Megan Diack, MBCHB, MRCSI, MCh, IRELAND Paula McQuail, MB FRCSI, IRELAND Fintan J. Shannon, FRCS (Tr/Orth), IRELAND
PROSPECTIVE RANDOMIZED STUDY: Double-bundle against single-bundle ACL reconstruction using allografts Abstract Presentation 5 minutes Edmundo Berumen Nafarrate, PhD, Prof., MEXICO Carlos Alejandro Vega Najera, MD, MEXICO Joel Alejandro Cabral, MD, MEXICO Jesus Javier Tonche, MD, MEXICO Ivan Ramos Moctezuma, Eng, MEXICO Luis Sigala Gonzalez, Eng, MEXICO Avril Pérez Fontes, MD, MEXICO Fatima Quintana Trejo, Eng, MEXICO Carlos Leal, MD, Prof., COLOMBIA
Skeletally Immature Patients with Classic Anterior Cruciate Ligament Bone Bruise Patterns Have a Higher Chance of Having an Intact Anterior Cruciate Ligament than Skeletally Mature Patients Abstract Presentation 6 minutes Aaron Baessler, MD, UNITED STATES Jessica M Buchman, MD, UNITED STATES Dexter Witte, MD, UNITED STATES Tyler Brolin, MD, UNITED STATES Thomas Ward Throckmorton, MD Frederick M. Azar, MD, UNITED STATES David Lee Bernholt, MD, UNITED STATES
PSM: Pivot Shift Meter Cellphone Application for Classifying ACL Injuries Abstract Presentation 5 minutes Edmundo Berumen Nafarrate, PhD, Prof., MEXICO Carlos Alejandro Vega Najera, MD, MEXICO Joel Alejandro Cabral, MD, MEXICO Luis Sigala Gonzalez, Eng, MEXICO Ivan Ramos Moctezuma, Eng, MEXICO Carlos Leal, MD, Prof., COLOMBIA Jesus Javier Tonche, MD, MEXICO Avril Pérez Fontes, MD, MEXICO Fatima Quintana Trejo, Eng, MEXICO
Tranexamic Acid Has No Effect On Post-Operative Hemarthrosis Or Pain Control Following Acl Reconstruction Using Bone Patella Tendon Bone Autograft: A Double-Blinded Randomized Control Trial Abstract Presentation 5 minutes Jordan W Fried, BM, UNITED STATES David Bloom, BA, UNITED STATES Eoghan T. Hurley, MB, BCh, MCh, IRELAND Samuel Baron, MD, UNITED STATES Kirk Anthony Campbell, MD, UNITED STATES Eric Jason Strauss, MD Laith M. Jazrawi, MD, UNITED STATES Michael J Alaia, MD, UNITED STATES

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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