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Selected Publication:
Baltic,A.
Allograft versus Allograft with Internal Bracing in Anterior Cruciate Ligament Reconstruction in Revision Cases after ACL re-tear
Humanmedizin; [Diplomarbeit] Medical University of Graz;2019. pp. 104
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- Authors Med Uni Graz:
- Advisor:
- Bernhardt Gerwin
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- Abstract:
- Introduction: Anterior cruciate ligament (ACL) ruptures are one of the most common sports-associated injuries. Increasing numbers of ACL reconstructions result in higher re-tear rates after return-to-sport and in a higher number of revisions. Allograft transplants may be a good alternative in complex revision cases. The use of so-called internal brace augmentation might help graft ingrowth by providing higher primary stability. This study aimed to investigate the outcome of patients with versus patients without internal brace augmentation in ACL revision cases with allografts. Material and Methods: This is a blinded, randomized controlled pilot study with 30 patients planned. All patients were treated with Achilles tendon allografts with bone blocks either with or without internal brace. Data (clinical outcomes, 6- and 13-month MRI scan, SF-36, VAS, IKDC, Lysholm Knee questionnaire, TAS and KOOS) were collected preoperatively as well as 6, 12 weeks, 6 and 13 months after surgery. Data of the 12-week follow-up results were included in this thesis. Results: There were 18 patients included in the study (16,7% female). Eight patients were treated with internal bracing (44.4%). The mean age was 29.4±7.8. There was no graft-failure in either group. The outcome scores did not differ between the two groups after 12 weeks, except for the IKDC being significantly better in the group without IB. The results of the scores were KOOS 82.6±9.8, IKDC 74.7±8.8 and a median Lysholm score of 94 (65-100) for the group without internal bracing versus KOOS 74.8±6.3, IKDC 63.9±8.7 and median Lysholm score of 67 (62-100) in the bracing group. Discussion: The results show satisfactory short-term outcomes in both groups. There were no re-ruptures or other complications in either group. There were no relevant clinical differences between the two groups. If internal bracing might support the allograft healing process and reduce re-ruptures has to be examined in the long term of this pilot study. Future studies then need to confirm the results in a larger cohort with adequate power and sample size calculation.