Short graft, short tunnel ACL reconstruction with single hamstring and internal brace leads to comparable outcomes to conventional double hamstring technique: A retrospective study.

Buranapuntaruk, Thana; Itthipanichpong, Thun; Tangpatthanasombat, Chatree; Limskul, Danaithep; Numkarunarunrote, Numphung; Buranapuntalug, Sasipa · J Exp Orthop · 2025

retrospective_cohort · Level III

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Abstract

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 (<i>p</i> = 0.32). The mean SNQ at 1-year postoperative MRI showed no significant difference (<i>p</i> = 0.21). Furthermore, no statistically significant differences were observed in the postoperative IKDC scores (<i>p</i> = 0.36), Lysholm scores (<i>p</i> = 0.22), Tegner activity scores (<i>p</i> = 0.30), or side-to-side differences (<i>p</i> = 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.