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.Purpose: 前交叉韧带重建（anterior cruciate ligament reconstruction, ACLR）中采用内支架增强技术可提升初始生物力学强度，但传统独立固定缝合带的技术存在因差动雨刷样运动导致隧道增宽的风险。本研究评估一种改良内支架（modified internal brace, MUIB）技术，该技术将缝合带缝合于移植物内部，旨在消除此类运动并加速术后康复。方法：本研究对36例接受全镜下单独腘绳肌自体移植物前交叉韧带重建的患者开展回顾性对照分析。其中18例采用标准技术（对照组），18例采用MUIB技术，即将三折叠FiberTape整合至移植物核心。在24个月随访时，评估患者报告结局指标（IKDC、Lysholm、Tegner评分）、回归运动时间（return to sport, RTS）、膝关节松弛度（Lachman试验、前抽屉试验）及并发症发生情况。结果：MUIB组的回归运动时间显著提前，平均恢复至伤前活动水平的时间为7.67±1.82个月，对照组为10.47±2.55个月（p=0.145），两者相差近3个月。客观评估方面，MUIB组的前后向稳定性显著更优，61.1%的患者前抽屉试验结果为0级，而对照组仅为11.1%（p=0.003）。最值得关注的是，MUIB队列中无移植物失效或翻修手术病例，而对照组的失效率为5.6%（n=1）。两组的功能评分（IKDC、Lysholm）均表现优异且无显著差异。结论：MUIB技术将缝合带与移植物整合为单一结构，是增强型前交叉韧带重建领域的重要进展。本研究中MUIB技术展现出良好的临床结局，无翻修病例且患者回归运动更早。