Internal bracing (IB) has recently emerged as a technique to reinforce reconstructed ligaments, aiming to enhance early-phase stability and reduce reinjury risks. Current clinical evidence indicates that IB augmentation may reduce rerupture rates in some cohorts, although the overall literature remains limited and heterogeneous. Choudhary et al conducted a study to compare functional outcomes of ACLR with and without IB. It has been published in Cureus journal.
It was a prospective observational study over 12 months at a tertiary care hospital. Fifty patients with ACL injuries were divided into two groups: Group A (n = 25) underwent arthroscopic ACLR with IB, and Group B (n = 25) without IB. The patients were assigned to the two groups based on their informed choice, ensuring balanced group distribution until the sample size was achieved. Baseline demographics, injury profiles, graft parameters, and Lysholm Knee Scores were recorded preoperatively and at 6 and 12 weeks postoperatively.
The key findings of the study were:
• The mean age was higher in Group A (32.92±10.91) than in Group B (26.56±8.66; p = 0.027).
• ACL tears were present in all Group B and 84% of Group A patients. Both groups had similar sociodemographic, clinical, and arthroscopic profiles.
• Group B had longer semitendinosus grafts (p = 0.007), but final graft dimensions were comparable.
• Lysholm scores were higher in Group A at all follow-up points (pre-op: 29.76 vs. 29.12; 6 weeks: 56.08 vs. 55.88; 12 weeks: 88.24 vs. 86.12), though not statistically significant.
• Minor complications, like pain, stiffness, and swelling, occurred equally across groups.
The authors concluded – “This study compared ACLR with and without IB. Group A (with bracing) had an older average age, and ACL tears were seen in all Group B patients and 84% of Group A patients; some Group A cases had associated avulsion or meniscal injury. Slip and fall was the most common mode of injury. Anterior drawer tests were positive in all cases, while Lachman and McMurray tests varied between groups. Most ACL injuries were complete or full-thickness, and all PCLs were intact. Group B had slightly longer harvested grafts, although final graft dimensions were similar. Lysholm scores were numerically higher in Group A at all follow-up points, but these differences were not statistically significant. Minor complications, such as pain, swelling, and stiffness, were comparable between groups. Overall, IB produced similar short-term functional outcomes without an apparent increase in early complications. Larger, multicenter studies with longer follow-up, randomized allocation, and objective stability measures are required to determine whether IB offers any meaningful clinical advantage over standard ACLR.”
Further reading:
Functional Outcomes Following Arthroscopic Anterior Cruciate Ligament Reconstruction (ACLR) With and Without Internal Bracing: A Prospective Study
Choudhary et al.
Cureus 17(12): e98455. DOI 10.7759/cureus.98455
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