Short graft, short tunnel ACL reconstruction with single hamstring and internal brace leads to comparable outcomes to...

The purpose of our study was to compare (1) ACL graft healing, (2) patient-reported outcome, and (3) complications after short graft (length < 65 mm), short tunnel (femoral tunnel < 20 mm) single hamstring ACL reconstruction with an internal brace (SGST-ACLR) technique and double hamstring autograft conventional ACL reconstruction (CON-ACLR) technique at minimum 2-year follow-up.

A retrospective cohort of patients underwent arthroscopic ACL reconstruction using a hamstring graft, with a minimum 2-year follow-up. Graft healing was evaluated at 1 year using a magnetic resonance imaging scan, with the mean signal-to-noise quotient ratio (SNQ) measured from three areas: proximal, middle, and distal to the ACL graft. Patients' demographics data, meniscal lesion, chondral lesion, time to operation, time to evaluation, PROMs (International Knee Documentation Committee [IKDC] scores, Tegner activity scale, and Lysholm score), and complications were evaluated. ACL laxity was measured using a side-to-side difference (SSD) by a lachmeter.

A total of 51 patients, comprising 25 in the SGST-ACLR group and 26 in the CONV-ACLR group, were analysed. The ACL graft diameter was comparable between the two groups (p = 0.32). The mean SNQ at 1-year postoperative MRI showed no significant difference (p = 0.21). Furthermore, no statistically significant differences were observed in the postoperative IKDC scores (p = 0.36), Lysholm scores (p = 0.22), Tegner activity scores (p = 0.30), or side-to-side differences (p = 0.38) at the final follow-up.

At two years postoperatively, this study demonstrates that SGST-ACLR with an internal brace provides comparable outcomes in all parameters to CONV-ACLR. Thus, SGST-ACLR offers a viable alternative technique for ACL reconstruction, with the added advantage of minimising graft usage.

Level IV, retrospective cohort study.