Objective Outcomes of All-inside Anterior Cruciate Ligament Reconstruction with and Without Internal Suture Augmentation Technique: Randomized Controlled Trial

Abstract

To report and compare patient outcomes (PROs) (IKDC score, Lysholm Score) and knee laxity using Lachmeter -The digital Rolimeter ® - among patients who underwent hamstrings autograft anterior cruciate ligament reconstruction (ACLR) with and without internal tape augmentation. Randomized trial of 41 patients in which 21 patients underwent all-inside ACLR with internal suture augmentation (Group I, Brace group) and 20 patients underwent all-inside ACLR without internal suture augmentation (Group II, non-brace group). Primary outcomes Lachmeter examinations and PROs were analyzed at 3,6,9 months postoperative. Secondary outcomes were graft failure, synovitis, and infection. Mean follow-up duration was 18 months ± 3.4. Date was expressed as Mean±SD for quantitative parametric data or number and percentage for categorized data. Delta change (dC) principle was used to test the actual mathematical change in the outcomes between 0-9 months and 3-9 months intervals postoperative. Lysholm score at 9-months was significant and better in brace group mean: 94 (92.4-96.5), p<0.005. Postoperative Lachmeter at 3,9 months was significant with less laxity in brace group mean: 1.98 (1.89- 2.07), 2.14 (2.06-2.22) p<0.005. dC Lachmeter in both intervals was significant with less laxity in brace group mean: .09 (.06-.11) p<0.001. dC IKDC score was significant in 3-9 months interval mean: .31 (.28-.35) p<0.001. dC Lysholm score was significant in 0-9 months interval mean: .86 (.72-.99) p<0.001. Both scores were better in brace-group. One graft failure was reported in Group II and one case of synovitis in Group I. All-inside ACLR with brace showed better laxity measures and lower failure rate at 9-months postoperative. However, the subjective functional outcomes did not show clear evidence of superiority in the suture tape augmentation group.