Paper 37: Peri-Operative Complications, Safety, and Early Outcomes of a Novel ACL+ALL Reconstruction Technique using Iliotibial Band Autograft vs. Patellar Tendon ACL Reconstruction: A Retrospective Pilot Study of the SATURN (Skeletally-Mature ACLR Technique Using Reinforcement Network) Study Group

Objectives: The iliotibial band (ITB) autograft has been historically used for physeal-sparing ACL reconstructions (ACLR) in skeletally immature children (Modified-Macintosh/Micheli-Kocher technique), with an extra-articular component that replicates anterolateral ligament reconstruction (ALLR). procedure demonstrated excellent return to sports (RTS), patient-reported outcomes (PROs), and relatively lower graft rupture rates than other techniques adolescents. However, there is only minimal evidence regarding the effectiveness of ITB technique, or similar modifications thereof, mature athletes. purpose current study was assess peri-operative complications, safety, early a novel ITB-ACLR+ALLR technique modified patients compare it gold standard patellar tendon/bone-tendon-bone (BTB-ACLR). hypothesis would be associated comparably low good PROs adolescents young adults. Methods: Patients aged 13-25 years-old closing closed physes who underwent either primary BTB-ACLR by one three surgeons at single institution over one-year period were included. utilized 20mm wide central strip autograft, transected 100-120mm proximal lateral epicondyle, tubularized whipstitches 40mm free end proximally left attached Gerdy’s tubercle distally. passed from outside through complete tunnel femoral condyle spanned anatomic ALL footprint extra-articularly extra-articularly, then tibial tunnel. affixed outside-in cortical interference screws within both tunnels. All intra-operative post-operative complications retrospectively recorded. Physical exam findings collected baseline, 3 6 month follow up visits, sport (RTS) testing performed 9 months, post-operatively, including Pedi-IKDC, HSS-Pedi FABS, KOOS, EQ-VAS, baseline follow-up ongoing collection 12 24 underway. Results: 71 (36 ITB, 35 BTB) included analysis. There no significant differences age, sex, BMI, pre-operative/baseline PROs, operative time, tourniquet RTS time between two treatment groups (Table 1). Peri-operative 1 case 8 months which patient non-compliance rehabilitation protocols/limitations (subsequently treated revision BTB-ACLR), medial meniscus tear 11 post-operatively partial meniscectomy), thigh cramping weeks (resolved spontaneously week), cases stiffness dynamic bracing PT), superficial wound infection 2 oral antibiotics). 4 arthrofibrosis 3-5 arthroscopic lysis adhesions). 3-month Lachman pivot-shift tests symmetry contralateral knee, IKDC grade. visits not statistically different 2). Conclusions: Preliminary safety clinical results suggest ACLR+ALLR utilizing may safe effective restoring knee stability returning sports, comparable function ACLR-BTB. Given advantages ITB-ACLR+ALLR—which include technically simple harvest/preparation/passage/fixation, optimization translational rotational stability, preservation extensor flexor muscle groups, smaller bony tunnels—ongoing monitoring cohort future randomized, prospective trials are warranted methodologically rigorous, multicenter fashion.