Comparative Outcome of ACL reconstruction using hamstring graft with and without suture augmentation

Suture augmentation in ACL tear – breaking the myth

Abstract

The anterior cruciate ligament (ACL) is one of the ligaments that stabilizes the knee joint, but injuries to this ligament are becoming more common. Anatomic ACL reconstruction aims to restore the ACL to its original dimensions, collagen orientation, and insertion sites, but complete restoration may not be possible. Suture augmentation (SA) is a technique that has gained attention as an augment to surgical treatment. It involves the use of autologous hamstring tendons with a braided ultra high–molecular weight polyester or polyethylene suture or suture tape to act as a secondary stabilizer until complete integration and ligamentization of the graft take place. This study aimed to compare the outcomes of ACL reconstruction using hamstring grafts with and without suture augmentation.

The study was conducted at a tertiary-level health care center, with 50 patients divided randomly into two groups: 25 patients for standard ACL reconstruction (Group A) and 25 patients for ACL reconstruction with suture augmentation (Group B). The study collected baseline clinical characteristics including demographic and clinical data. All participants gave informed consent before enrollment. The study evaluated patients by range of motion (ROM), pain assessment using the numeric pain rating scale (NPRS), and functional outcomes by the Lysholm score and International Knee Documentation Committee (IKDC) score.

The study found a statistically significant improvement in both groups in ROM, NPRS scores, and functional outcomes at 1 and 6 months. The mean age was 25.5 years with 96% male and 4% female participants. There was no significant difference between both groups in terms of IKDC score. LYSHOLM score showed a remarkable improvement in both groups. The study concluded that suture augmentation could be an effective technique for ACL reconstruction, with similar outcomes to standard ACL reconstruction.