Revision ACL Reconstruction with Hamstring Autograft from the Contralateral Leg With and Without Internal Brace: A Comparative Study.

Abstract

Introduction: Revision anterior cruciate ligament (ACL) reconstruction remains a clinical challenge, with high failure rates compared to primary procedures. The use of an internal brace (IB) as augmentation has been proposed to enhance stability and improve functional outcomes.1 The purpose of this article is to compare the clinical and radiological outcomes of revision ACL reconstruction using hamstring autograft from the contralateral leg, with and without an internal brace, at 24 months postoperatively.2 Materials and Methods: Thirty patients undergoing revision ACL reconstruction were randomized into two groups: Group A (n=15) underwent hamstring autograft reconstruction with IB augmentation, while Group B (n=15) received hamstring autograft alone. Clinical assessments included the International Knee Documentation Committee (IKDC) score, Lysholm score, Tegner activity scale, and visual analog scale (VAS) for pain.3 KT-1000 arthrometry measured anterior tibial translation.4 Magnetic resonance imaging (MRI) signal intensity was analyzed to assess graft maturation.5 Results: Group A demonstrated superior postoperative IKDC (88.7 ± 4.2 vs. 82.5 ± 5.1, p<0.01),6 Lysholm (91.4 ± 3.8 vs. 85.2 ± 4.3, p<0.01)7, and Tegner scores (7.2 ± 1.1 vs. 6.5 ± 1.3, p=0.03).8 VAS pain was significantly lower in Group A (1.3 ± 0.7 vs. 2.1 ± 0.8, p=0.02).9 KT-1000 demonstrated reduced anterior laxity in Group A at 24 months (2.5mm vs. 3.7mm, p<0.01).10 MRI analysis showed faster graft maturation in the IB group.11 Graft re-rupture occurred in one patient (6.7%) in Group A versus four patients (26.7%) in Group B (p=0.04).12 Conclusion: Internal bracing in revision ACL reconstruction provides enhanced knee stability, improved functional outcomes, and reduced re-rupture rates at 24 months.13.