Comparative Outcome of ACL reconstruction using hamstring graft with and without suture augmentation Suture augmentation in ACL tear – breaking the myth

The anterior cruciate ligament (ACL) is a vital knee joint stabilizer with rising injury rates. Anatomic ACL reconstruction (ACLR) aims to restore the ACL to its original dimensions, collagen orientation, and insertion sites, but complete restoration may not be possible. Suture augmentation (SA) involves the use of autologous hamstring tendons with a braided ultra-high molecular weight polyester or polyethylene (UHMWPE) suture or suture tape to act as a secondary stabilizer until complete integration. This study aimed to compare the outcomes of ACLR using hamstring grafts with and without SA.

This trial was conducted at a tertiary-level health care center, with 50 patients divided randomly into two groups: 25 patients for standard ACLR (group A) and25 patients for ACLR with SA (group B). Participants provided informed consent. Baseline clinical characteristics including range of motion (ROM), pain [Numeric Pain Rating Scale (NPRS)], and functional outcomes [Lysholm and International Knee Documentation Committee (IKDC) scores] were collected.

The mean age was 25.5 years, with 96% male and 4% female participants. A statistically significant improvement was found in both groups in ROM, NPRS scores, and functional outcomes at 1 and 6 months. There was no significant difference in both groups regarding the IKDC score. Lysholm’s score showed a remarkable improvement in both groups.

SA could be an effective technique for ACLR, with comparable outcomes to standard ACLR.