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. 2024 Apr 17;25(1):301.
doi: 10.1186/s12891-024-07426-w.

Additional suture augmentation to anterior cruciate ligament reconstruction with hamstring autografts bring no benefits to clinical results, graft maturation and graft-bone interface healing

Qingyang Meng #  1   2 , Ruilan Dai #  1   3 , Cheng Wang  1   2 , Weili Shi  1   2 , Yanfang Jiang  1   2 , Ningjing Liu  1   2 , Rui Li  1   2 , Yingfang Ao  4   5 , Xi Gong  6   7 , Yong Ma  8   9
Affiliations

Additional suture augmentation to anterior cruciate ligament reconstruction with hamstring autografts bring no benefits to clinical results, graft maturation and graft-bone interface healing

Qingyang Meng et al. BMC Musculoskelet Disord. .

Abstract

Background: From the perspective of graft protection and early rehabilitation during the maturation and remodeling phases of graft healing, suture augmentation (SA) for anterior cruciate ligament reconstruction (ACLR) has attracted more and more attention.

Study design: Retrospective study.

Purpose: To determine whether the additional SA affects clinical results, graft maturation and graft-bone interface healing during two years follow-up after ACLR.

Methods: 20 ACLRs with additional SA (ACLR-SA group) and 20 ACLRs without additional SA (ACLR group) were performed between January 2020 and December 2021 by the same surgeon and were retrospectively analyzed. Pre- and postoperative International Knee Documentation Committee (IKDC) scores, Lysholm scores, graft failure and reoperation were evaluated. The signal/noise quotient (SNQ) of autografts and the signal intensity of graft-bone interface were analyzed. All 40 patients in ACLR-SA group and ACLR group completed 2-years follow-up.

Results: There was no patient in the two cohorts experienced graft failure and reoperation. The postoperative IKDC and Lysholm scores have been significantly improved compared with preoperative scored in both ACLR-SA group and ACLR group, however, there was no significant difference between two groups. The SNQ of proximal graft of ACLR-SA group (14.78 ± 8.62 vs. 8.1 ± 5.5, p = 0.041) was significantly greater while the grades of graft-bone interface healing of posterior tibial was significantly lower than that of ACLR group at 1-year postoperatively (p = 0.03), respectively. There were no significant differences between the two groups of the SNQ of proximal, distal medial graft segments, and the graft-bone interface healing grades of anterior femoral, posterior femoral, anterior tibial and posterior tibial at other time points (p>0.05).

Conclusions: The additional SA in ACLR had no effect on IKDC scores, Lysholm scores, graft maturation and graft-bone interface healing at 2-year postoperatively. Our research does not support the routine use of SA in ACLR.

Keywords: Anterior cruciate ligament reconstruction; Graft maturation; Graft-bone interface healing; Suture augmentation.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The evaluation of autograft maturation and graft-bone interface healing on MRI images. A. The SI of hamstring autograft (yellow circle) was obtained on the proximal, medial and distal segments of graft. SNQ = (SI of hamstring autograft - SI of quadriceps tendon) / SI of background. B and C. The anterior and posterior SI of graft-bone interface at femoral tunnel and 1/3 proximal tibial tunnel (yellow imaginary line) was obtained and classified into 4 grades. SI: signal intensity, SNQ: signal/noise quotient
See this image and copyright information in PMC

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