Excellent 2-Year Outcomes of MUIB All-Inside ACL Reconstruction: A Registry-Based Analysis of 63 Patients with Zero Graft Failure
Description
Background: Anterior cruciate ligament reconstruction (ACLR) remains a cornerstone of orthopaedic sports medicine, yet graft failure rates is high despite advances in surgical techniques. The Modified Internal Bracing (MUIB) technique combines all-inside ACLR with internal suture augmentation, potentially offering enhanced graft protection and improved outcomes. Methods: This retrospective cohort study evaluated 63 patients who underwent isolated primary all-inside ACLR using the MUIB technique (19 allograft, 44 autograft) between 2020-2024. Outcome measures included International Knee Documentation Committee (IKDC) scores, Visual Analog Scale (VAS) pain scores, graft failure rates, Single Leg Hop Test (SLHT) performance, and complication profiles at 3, 6, 12, and 24 months postoperatively. Results: Both allograft and autograft groups demonstrated significant improvement from preoperative to 2-year follow-up (p<0.001), achieving ceiling IKDC scores of 100. Complete pain resolution (VAS 0) was achieved by 6 months in both groups. Notably, no graft re-tears were documented throughout the 2-year follow-up period, with 95.2% of patients achieving SLHT >90% at 12 months. No infections, arthrofibrosis, or hardware-related complications requiring reoperation were recorded. Conclusions: The MUIB all-inside ACLR technique yields excellent 2-year outcomes with zero graft failure rate, complete pain resolution, and exceptional functional recovery. Critically, allograft and autograft outcomes were equivalent across all measures, suggesting that the MUIB technique may mitigate the historical disadvantages of allograft use. These findings support the MUIB technique as a standard of care for isolated ACL reconstruction, though larger prospective studies are warranted to confirm these promising results.