Innovations in knee surgery: Internal brace for ACL reconstruction

Recent advancements in orthopaedic surgical techniques have introduced avant-garde solutions to enhance outcomes for patients undergoing ACL reconstruction. One such innovation is the use of an internal brace to provide support to the reconstructed ligament during the healing process.

Mr William Wilson, leading consultant orthopaedic knee surgeon, addresses common questions about using an internal brace for ACL reconstruction to help patients better understand its applications, risks, and long-term benefits.

Is the internal brace suitable for all ACL injuries?

Yes, the internal brace can be used in all patients. The internal brace protects the ACL graft, acting as a ‘seatbelt mechanism’, increasing the strength of the construct and reducing the risk of future injury. It is most useful for patients who engage in physically demanding activities that place significant stress on the knee, such as professional athletes.

In some scenarios, particularly when ACL tears are identified early, the internal brace can be used to protect a direct repair of the torn ACL, negating the need to harvest tendon from elsewhere in your leg to form a graft.

Your orthopaedic knee surgeon will evaluate the specifics of your injury and your individual circumstances, including age, activity level, and overall knee health before determining whether this technique is suitable for you.

What is involved in the internal brace technique in ACL reconstruction?

The internal brace is a synthetic ligament augmentation system designed to work alongside the natural graft used in ACL reconstruction, facilitating a quicker return to activities while maintaining the integrity of the reconstructed ligament.

During the surgery, a graft is typically harvested from your hamstring, patellar or quadriceps tendon, and is secured to replace the torn ligament.

The internal brace is passed alongside the graft and then anchored at both ends with appropriate tension, using small bioabsorbable screws. This dual-support system will ensure the knee is stabilised during the early stages of healing, reducing the risk of re-injury.

Are there any risks associated with using an internal brace?

As with any surgical intervention, there are potential risks associated with using an internal brace in ACL reconstruction. However, the risks are generally considered low. Although the theory of the internal brace is to reduce the risk of re-injury, unfortunately this risk can never be completely eliminated. While short to mid-term research has shown very promising results for the use of internal brace, long-term outcome studies are still awaited.

Other general surgical risks, such as infection, bleeding, or stiffness in the knee joint, apply to the surgery but aren’t specific to the internal brace itself.

How does the internal brace affect the long-term durability of the ACL reconstruction?

One of the significant advantages of using an internal brace in ACL reconstruction is its potential to enhance the long-term durability of the reconstructed ligament. The internal brace allows the biological tissue to heal without being stretched out and reduces the likelihood of early graft failure.

Studies have also shown that the internal brace can help maintain knee stability even during high-impact activities. Furthermore, the internal brace acts as a safety net in cases where the graft may otherwise be at risk of re-tearing.

After returning to sport, some patients who undergo ACL reconstruction with an internal brace report higher levels of confidence in their knee stability, which might translate to improved performance in physical activities and a lower risk of secondary injuries.

If you would like to book an appointment with Mr William Wilson, head on over to his Top Doctors profile today.