Cohort study of short-term outcomes after ACL-reconstruction using autograft with internal brace reinforcement versus isolated autograft demonstrating no significant difference.

Anterior cruciate ligament reconstruction Hamstring autograft Internal brace Short-term outcomes

Journal

Journal of orthopaedics
ISSN: 0972-978X
Titre abrégé: J Orthop
Pays: India
ID NLM: 101233220

Informations de publication

Date de publication:
Sep 2023
Historique:
received: 28 04 2023
revised: 23 07 2023
accepted: 28 07 2023
pmc-release: 01 09 2024
medline: 18 8 2023
pubmed: 18 8 2023
entrez: 18 8 2023
Statut: epublish

Résumé

The gold standard treatment for Anterior Cruciate Ligament injury is reconstruction (ACL-R). Graft failure is the concern and ensuring a durable initial graft with rapid integration is crucial. Graft augmentation with implantable devices (internal brace reinforcement) is a technique purported to reduce the risk of rupture and hasten recovery. Few studies have examined these techniques, in particular when compared to non-augmented grafts. This study assesses the short-term outcome of ACL-R using augmented and non-augmented hamstring tendon autografts. This was a retrospective cohort study comparing augmented and non-augmented ACL-R. All procedures were performed in a single centre using the same technique. The Knee injury and Osteoarthritis Outcome Score [KOOS] was used to assess patient-reported outcomes. There were 70 patients in the augmented and 111 patients in the control group. Mean graft diameter in the augmented group was 8.82 mm versus 8.44 mm in the non-augmented. Six strand graft was achievable in 73.5% of the augmented group compared to 33% in the non-augmented group. Two graft failures were reported in the non-augmented group and none in the augmented group. Patient satisfaction rates were higher in the augmented group. There was a statistically insignificant improvement in the postoperative KOOS in the augmented group compared to the non-augmented group (p 0.6). Irrespective of augmentation status, no correlation was found between the functional score and age, or femoral tunnel width. No statistically significant difference was demonstrated in the short-term functional outcome of ACL reconstruction using an augmented or non-augmented hamstring graft. Augmented ACL-R may achieve superior graft diameters, failure rates and patient reported outcomes when compared to nonaugmented ACL-R. Prospective trials are needed to examine this further.

Sections du résumé

Background UNASSIGNED
The gold standard treatment for Anterior Cruciate Ligament injury is reconstruction (ACL-R). Graft failure is the concern and ensuring a durable initial graft with rapid integration is crucial. Graft augmentation with implantable devices (internal brace reinforcement) is a technique purported to reduce the risk of rupture and hasten recovery. Few studies have examined these techniques, in particular when compared to non-augmented grafts. This study assesses the short-term outcome of ACL-R using augmented and non-augmented hamstring tendon autografts.
Methods UNASSIGNED
This was a retrospective cohort study comparing augmented and non-augmented ACL-R. All procedures were performed in a single centre using the same technique. The Knee injury and Osteoarthritis Outcome Score [KOOS] was used to assess patient-reported outcomes.
Results UNASSIGNED
There were 70 patients in the augmented and 111 patients in the control group. Mean graft diameter in the augmented group was 8.82 mm versus 8.44 mm in the non-augmented. Six strand graft was achievable in 73.5% of the augmented group compared to 33% in the non-augmented group. Two graft failures were reported in the non-augmented group and none in the augmented group. Patient satisfaction rates were higher in the augmented group. There was a statistically insignificant improvement in the postoperative KOOS in the augmented group compared to the non-augmented group (p 0.6). Irrespective of augmentation status, no correlation was found between the functional score and age, or femoral tunnel width.
Conclusion UNASSIGNED
No statistically significant difference was demonstrated in the short-term functional outcome of ACL reconstruction using an augmented or non-augmented hamstring graft. Augmented ACL-R may achieve superior graft diameters, failure rates and patient reported outcomes when compared to nonaugmented ACL-R. Prospective trials are needed to examine this further.

Identifiants

pubmed: 37593689
doi: 10.1016/j.jor.2023.07.030
pii: S0972-978X(23)00183-6
pmc: PMC10429725
doi:

Types de publication

Journal Article

Langues

eng

Pagination

115-120

Informations de copyright

© 2023 Professor P K Surendran Memorial Education Foundation. Published by Elsevier B.V. All rights reserved.

Références

Arthroscopy. 1999 May;15(4):422-32
pubmed: 10355719
SICOT J. 2021;7:16
pubmed: 33749586
J Orthop Res. 1997 Jan;15(1):1-10
pubmed: 9066520
Arthrosc Tech. 2014 Aug 11;3(4):e505-8
pubmed: 25276610
J Exp Orthop. 2018 Jun 15;5(1):20
pubmed: 29904897
Arthroscopy. 2013 Oct;29(10):1712-21
pubmed: 23859954
J Bone Joint Surg Am. 2019 Oct 16;101(20):1812-1820
pubmed: 31626005
Clin Biomech (Bristol, Avon). 2020 Jul;77:105065
pubmed: 32504897
Arthroscopy. 2015 May;31(5):957-68
pubmed: 25620500
Arthroscopy. 2011 Dec;27(12):1697-705
pubmed: 22137326
BMC Musculoskelet Disord. 2021 Apr 30;22(1):399
pubmed: 33931067
Biomaterials. 2013 Sep;34(29):7048-63
pubmed: 23790438
Knee. 2000 Jul 1;7(3):157-163
pubmed: 10927209
EFORT Open Rev. 2017 Mar 13;1(11):398-408
pubmed: 28461919
J Bone Joint Surg Am. 2017 Jun 7;99(11):897-904
pubmed: 28590374
Clin Sports Med. 2007 Oct;26(4):661-81
pubmed: 17920959
Br J Sports Med. 2014 Nov;48(21):1543-52
pubmed: 25157180
Clin Sports Med. 2017 Jan;36(1):25-33
pubmed: 27871659
Arthroscopy. 2017 Aug;33(8):1575-1583
pubmed: 28502387
Br J Sports Med. 2020 Mar;54(5):286-291
pubmed: 30661013
Knee Surg Sports Traumatol Arthrosc. 2016 Jun;24(6):1845-51
pubmed: 27141865
Acta Orthop Scand. 1990 Jun;61(3):217-24
pubmed: 2371814
Am J Sports Med. 2006 Dec;34(12):2026-37
pubmed: 17092921
Arthroscopy. 2013 Jun;29(6):1079-88
pubmed: 23726110
J Orthop Traumatol. 2016 Dec;17(4):353-360
pubmed: 27108426
Br J Sports Med. 2011 Jun;45(7):596-606
pubmed: 21398310
Sports Med. 2017 Feb;47(2):221-232
pubmed: 27402457
Knee Surg Relat Res. 2013 Dec;25(4):165-73
pubmed: 24368993
Arthroscopy. 2019 Nov;35(11):3107-3113
pubmed: 31439458
Orthop J Sports Med. 2019 Oct 30;7(10):2325967119879079
pubmed: 31696135
Arthroscopy. 2003 Dec;19 Suppl 1:14-29
pubmed: 14673415
J Am Osteopath Assoc. 1997 Apr;97(4):221-6
pubmed: 9154740
Health Qual Life Outcomes. 2003 Nov 03;1:64
pubmed: 14613558
Acta Biomed. 2020 May 30;91(4-S):136-145
pubmed: 32555088
Clin J Sport Med. 2012 Mar;22(2):116-21
pubmed: 22343967
Orthop Surg. 2018 May;10(2):144-151
pubmed: 29624874
Asia Pac J Sports Med Arthrosc Rehabil Technol. 2015 Feb 09;2(1):15-26
pubmed: 29264235
Expert Rev Med Devices. 2009 Jan;6(1):61-73
pubmed: 19105781
Orthop Traumatol Surg Res. 2015 Sep;101(5):535-8
pubmed: 25998274

Auteurs

Rahul Mohan (R)

Mersey and West Lancashire Teaching Hospitals NHS Trust, Whiston Hospital, Prescot, L35 5DR, United Kingdom.

Tariq Adam Kwaees (TA)

Mersey and West Lancashire Teaching Hospitals NHS Trust, Whiston Hospital, Prescot, L35 5DR, United Kingdom.

Terin Thomas (T)

Mersey and West Lancashire Teaching Hospitals NHS Trust, Whiston Hospital, Prescot, L35 5DR, United Kingdom.

Ravi Pydisetty (R)

Mersey and West Lancashire Teaching Hospitals NHS Trust, Whiston Hospital, Prescot, L35 5DR, United Kingdom.

Classifications MeSH