• Full Name: PORNPAT SIRIPHANPORN
• Affiliation/Institution: Srinagarind Hospital, Faculty of Medicine, Khon Kaen University
• Country: Thailand

Background: All-inside anterior cruciate ligament reconstruction (ACLR) uses a single-tendon, quadrupled soft-tissue graft configured as a closed-loop construct. Several graft preparation techniques have been described, but their relative biomechanical performance remains unclear.

Objective: To compare the biomechanical properties of 3 graft preparation techniques used in all-inside ACLR: side-to-side fixation, end-to-end fixation, and side-to-side fixation with suture tape augmentation

Study Design: Controlled laboratory study.

Methods: 9 Human cadaveric knees underwent all-inside ACL reconstruction using grafts prepared with 1 of 3 configurations: side-to-side fixation, end-to-end fixation, or side-to-side fixation with suture tape augmentation. Anterior tibial translation was measured under a 134-N anterior tibial load at multiple knee flexion angles in intact and reconstructed states. Secondary outcomes included ultimate load to failure, construct stiffness, elongation during cyclic loading, and failure mode. Between-group comparisons were performed using 1-way analysis of variance with post hoc testing.

Results: In the intact state, anterior tibial translation did not differ among groups at any flexion angle. After reconstruction, a significant difference in anterior tibial translation was observed at 45° of knee flexion (P = .037), with the end-to-end fixation group demonstrating less translation than the side-to-side fixation group. Ultimate load to failure was significantly greater in the suture tape–augmented group (972 ± 256 N) compared with the side-to-side fixation group (464 ± 44 N; P = .008). No significant differences were observed in stiffness or cyclic elongation among groups.