Summary

ACL reconstruction surgery with hybrid graft allows to significantly increase the diameter of the graft and achieves good clinical and functional results reported by patients.

Abstract

Introduction

The success of an anterior cruciate ligament (ACL) reconstruction is multifactorial, with graft selection being a key factor in the equation. The use of autologous graft is considered the "gold standard" in ACL reconstruction surgery, however, evidence has shown that autografts with diameters less than 8 mm have a higher rate of graft failure. The use of hybrid grafts allows the surgeon to customize the size of the graft, hoping to increase inappropriate diameters and achieve better results.

Objective

Evaluate functional results of patients operated with hybrid grafts in ACL reconstruction surgery.

Methods

Retrospective cohort study. A database of all patients with primary anterior cruciate ligament reconstruction surgery from 2015 to 2021 was used, obtaining 20 patients operated on with the hybrid technique. Subsequently, a follow-up was carried out through the review of files and surveys by telephone and email. For the statistical analysis, "t student" and analysis of covariance were used, for

Significance

of 5% (p<0.05).

Results

The average age was 25.6 years (SD 8.59). 65% were female. All harvested autografts had a diameter of less than 8 mm, with an average of 6.8 mm (range 5-7.5 mm). The average size increased after allograft augmentation by 2 mm, with a mean of 9.1 mm (range 8-10.5mm; p=0.0001). All patients performed sports activity before and after the injury. The most practiced sport in the preoperative period was soccer (50%). After surgery, the most practiced sport was functional training (50%) and soccer came second with 20%. The average Cincinnati score before the injury was 89. After ACL reconstruction surgery it was 86, with a decrease that did not achieve statistical significance (p=0.229). The subjective pre-injury IKDC was 100 in all patients. After surgery, an average decrease of 0.68 points (p=0.168) was observed, with a mean score of 99.32. The preoperative Lysholm score was 100 on average and 94.2 postoperative, with an average decrease of 5.8 points, this being statistically significant (p=0.0002). The average Tegner before surgery was 6.3, and after surgery it was 5.6, with a statistically significant decrease of 0.7 points (p=0.009). No correlation was found between sex and age with the change in the scores of the different scales. Only 1 patient presented a rupture of the plasty, which required revision surgery.

Conclusion

ACL reconstruction surgery with hybrid graft allows to significantly increase the diameter of the graft and achieves good clinical and functional results reported by patients, allowing an adequate return to sports in most of them.