Analysis of Graft Types Augmented With an Internal Brace for ACL Reconstruction: A Systematic Review.

Autor:	Maginnis C; Louisiana State University School of Medicine, New Orleans, Louisiana, USA., Root C; Department of Orthopaedic Surgery, University of Kansas School of Medicine, Kansas City, Kansas, USA., Schiavo JH; Louisiana State University Health Science Center, New Orleans, Louisiana, USA., Ierulli VK; Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, Louisiana, USA., Vopat B; Department of Orthopaedic Surgery, University of Kansas School of Medicine, Kansas City, Kansas, USA., Mulcahey MK; Department of Orthopaedic Surgery & Rehabilitation, Loyola University Medical Center, Maywood, Illinois, USA.
Jazyk:	angličtina
Zdroj:	The American journal of sports medicine [Am J Sports Med] 2024 Jul; Vol. 52 (9), pp. 2415-2423. Date of Electronic Publication: 2024 Jan 25.
DOI:	10.1177/03635465231196157
Abstrakt:	Background: New techniques are being developed to decrease the failure rate of anterior cruciate ligament (ACL) grafts and prevent revision surgery. One such technique involves high-strength suture tape (ST), also referred to as internal bracing. Recent literature has highlighted the use of ST for ACL reconstruction, but no study has compared ST augmentation between graft types. Purpose: To compare the use of ST augmentation for ACL reconstruction based on the type of graft used (ie, bone-patellar tendon-bone [BPTB], quadriceps, hamstring). Study Design: Systematic review; Level of evidence, 5. Methods: An online search of multiple databases was performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and was completed April 2022 to identify studies related to ST augmentation of ACL grafts. Results: Of 926 studies identified, 10 met inclusion criteria. Five studies (50%) used hamstring tendon (HT), 3 (30%) used quadriceps tendon (QT), 1 (10%) used BPTB, and 1 (10%) used both HT and QT grafts. HT autografts augmented with ST had decreased dynamic and peak elongation (15%-56%), increased load to failure, and increased initial and final dynamic stiffness compared with controls. There was no significant difference in postoperative physical examination findings (range of motion, Lachman, pivot shift), except that ST-augmented grafts had significantly less laxity after surgery compared with HT alone (0.8 vs 1.9 mm; P < .05). QT allografts with ST augmentation showed increased graft strength. Human QT autograft studies showed higher Knee injury and Osteoarthritis Outcome Score scores compared with controls. BPTB allografts with ST augmentation had decreased cyclic displacement by 31% ( P = .015) and increased load (758 ± 128 N; P < .001) and stiffness (156 ± 23 N/mm; P = .003) compared with nonaugmented groups. The complication rate was low or showed no increase in the ST augmentation groups compared with control groups. Conclusion: HT, QT, and BPTB grafts augmented with ST demonstrate an effective method for ACL reconstruction. All graft types with ST augmentation showed no evidence of clinical disadvantage, with some studies indicating significant biomechanical or clinical advantages compared with conventional ACL reconstruction. Competing Interests: One or more of the authors has declared the following potential conflict of interest or source of funding: B.V. has received consulting fees from Artelon, International Life Sciences, and DePuy Synthes Products; support for education from Titan Surgical Group; travel expenses from Novastep Inc; and holds stock or stock options in Altior, Carbon 22, and Spinal Simplicity. M.K.M. has received consulting fees from Arthrex and support for education from Alon Medical Technology. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.
Databáze:	MEDLINE
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