A COMPARATIVE ANALYSIS OF CLINICAL OUTCOMES FOLLOWING ACL RECONSTRUCTION WITH AND WITHOUT A MODIFIED INTERNAL BRACE AUGMENTATION TECHNIQUE (MUIB)

Purpose: While internal bracing augmentation in anterior cruciate ligament reconstruction (ACLR) improves initial biomechanical strength, traditional techniques that fix the suture tape independently risk tunnel widening from differential windshield-wiper motion. This study evaluates a modified internal brace (MUIB) technique, where the tape is sutured within the graft, designed to eliminate this motion while accelerating recovery. Methods: A retrospective comparative analysis was performed on 36 patients undergoing all-inside isolated ACLR with hamstring autograft. Eighteen patients received the standard technique (control), and 18 received the MUIB technique, where a tri-folded FiberTape was integrated into the graft core. Patient-reported outcomes (IKDC, Lysholm, Tegner), time to return to sport (RTS), knee laxity (Lachman, anterior drawer tests), and complications were assessed at 24-month follow-up. Results: The MUIB group demonstrated an acceleration in RTS, returning to preinjury activity at a mean of 7.67 ± 1.82 months, compared to 10.47 ± 2.55 months in the control group (p=0.145), a reduction of nearly 3 months. Objectively, the MUIB group exhibited significantly superior anteroposterior stability, with 61.1% achieving a Grade 0 anterior drawer test versus only 11.1% in the control group (p=0.003). Most notably, there were zero graft failures or revision surgeries in the MUIB cohort, contrasting with a 5.6% (n=1) failure rate in the control group. Functional scores (IKDC, Lysholm) were excellent and equivalent between groups. Conclusion: The MUIB technique represents a significant advance in augmented ACLR by incooperating the suture tape and graft into a single construct. MUIB technique demonstrate favourable outcome in this study, showing zero rate of revision and earlier return to play.