Comparing Outcomes of ACL Reconstruction with and Without Cyclic Graft Loading: A Two-Year Minimum Follow-Up Study.

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomechanical Engineering

Background:

• The role of cyclic graft loading in anterior cruciate ligament (ACL) reconstruction is not fully established.
• Debate exists regarding its necessity and impact on surgical outcomes.

Purpose of the Study:

• To compare clinical outcomes of ACL reconstruction with versus without intraoperative cyclic graft loading.
• To evaluate the effect of cyclic loading on graft re-rupture rates and knee stability.

Main Methods:

• Retrospective comparative study of 216 patients undergoing ACL reconstruction with hamstring autografts.
• Two groups: cyclic graft loading (n=104) and no cyclic loading (n=112).
• Outcomes assessed: re-rupture rates, knee laxity (Rolimeter®), Lysholm, and IKDC scores at minimum 2-year follow-up.

Main Results:

• No significant difference in re-rupture rates between groups (2.5% vs. 2.9%, p=0.78).
• Similar mean side-to-side laxity differences (1.1 mm vs. 1.2 mm, p=0.39).
• No significant differences in patient-reported Lysholm or IKDC scores.

Conclusions:

• This retrospective study found no statistically significant difference between ACL reconstruction with or without cyclic graft loading.
• Findings suggest cyclic loading may not be essential for comparable outcomes in this cohort.
• Caution is advised due to potential temporal confounding; prospective randomized trials are recommended.