Abstract
PURPOSE: The purpose of our study was to compare (1) ACL graft healing, (2) patient-reported outcome, and (3) complications after short graft (length < 65 mm), short tunnel (femoral tunnel < 20 mm) single hamstring ACL reconstruction with an internal brace (SGST-ACLR) technique and double hamstring autograft conventional ACL reconstruction (CON-ACLR) technique at minimum 2-year follow-up. METHODS: A retrospective cohort of patients underwent arthroscopic ACL reconstruction using a hamstring graft, with a minimum 2-year follow-up. Graft healing was evaluated at 1 year using a magnetic resonance imaging scan, with the mean signal-to-noise quotient ratio (SNQ) measured from three areas: proximal, middle, and distal to the ACL graft. Patients' demographics data, meniscal lesion, chondral lesion, time to operation, time to evaluation, PROMs (International Knee Documentation Committee [IKDC] scores, Tegner activity scale, and Lysholm score), and complications were evaluated. ACL laxity was measured using a side-to-side difference (SSD) by a lachmeter. RESULTS: A total of 51 patients, comprising 25 in the SGST-ACLR group and 26 in the CONV-ACLR group, were analysed. The ACL graft diameter was comparable between the two groups (p = 0.32). The mean SNQ at 1-year postoperative MRI showed no significant difference (p = 0.21). Furthermore, no statistically significant differences were observed in the postoperative IKDC scores (p = 0.36), Lysholm scores (p = 0.22), Tegner activity scores (p = 0.30), or side-to-side differences (p = 0.38) at the final follow-up. CONCLUSION: At two years postoperatively, this study demonstrates that SGST-ACLR with an internal brace provides comparable outcomes in all parameters to CONV-ACLR. Thus, SGST-ACLR offers a viable alternative technique for ACL reconstruction, with the added advantage of minimising graft usage. LEVEL OF EVIDENCE: Level IV, retrospective cohort study.