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Revision ACL Reconstruction with Hamstring Autograft from the Contralateral Leg With and Without Internal Brace: A

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Revision anterior cruciate ligament (ACL) reconstruction with an internal brace (IB) significantly improves knee stability and function. This study found IB augmentation reduced pain, laxity, and graft re-rupture rates compared to traditional methods.

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Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Biomechanical Engineering

Background:

  • Revision anterior cruciate ligament (ACL) reconstruction presents challenges with high failure rates.
  • Internal bracing (IB) is a potential augmentation strategy to improve stability and outcomes.
  • Hamstring autograft from the contralateral leg is a common graft choice for revision ACL surgery.

Purpose of the Study:

  • To compare clinical and radiological outcomes of revision ACL reconstruction with and without internal brace augmentation.
  • To evaluate the efficacy of internal bracing in enhancing stability and reducing re-rupture rates.
  • To assess graft maturation and functional recovery at 24 months postoperatively.

Main Methods:

  • Randomized controlled trial comparing hamstring autograft ACL reconstruction with (Group A) and without (Group B) internal brace augmentation.
  • Thirty patients were randomized into two groups (n=15 each).
  • Clinical outcomes assessed using IKDC, Lysholm, Tegner, and VAS scores; radiological assessment via KT-1000 arthrometry and MRI signal intensity.

Main Results:

  • Group A (with IB) showed significantly higher IKDC, Lysholm, and Tegner scores.
  • Group A exhibited lower VAS pain scores and reduced anterior tibial translation (KT-1000).
  • Faster graft maturation on MRI and a significantly lower graft re-rupture rate (6.7% vs. 26.7%) were observed in Group A.

Conclusions:

  • Internal bracing augmentation in revision ACL reconstruction enhances knee stability.
  • IB improves functional outcomes and patient-reported pain at 24 months.
  • Internal bracing significantly reduces the rate of graft re-rupture in revision ACL reconstruction.