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Current Issue - July 2026, Volume 20, Issue No. 2

Official Journal of Malaysian Orthopaedic Association and ASEAN Orthopaedic Association

Internal Bracing as a Biological ‘Safety Belt’ in Protected ACL Graft Survival After High-Impact Trauma in Revision Reconstruction: A Case Report

Abstract

Anterior cruciate ligament (ACL) revision surgeries remain challenging, with higher failure rates than primary reconstructions. This case report aims to demonstrate the clinical outcomes of revision ACL reconstruction using the Modified UKM Internal Bracing (MUIB) technique and evaluate its protective role in maintaining graft integrity after high-impact trauma. This case report describes a 37-year-old male with recurrent ACL graft failure who underwent revision reconstruction using the MUIB technique. Post-operatively, the patient achieved excellent knee stability with no functional limitations at the post-operative nine month. Following a high-energy motorcycle accident, a second-look arthroscopy after one year from the last reconstruction revealed only a small tear of the ACL graft and just one of the strands of MUIB ruptured. There was also no evidence of tunnel widening, a common complication in revision cases. These findings demonstrate that MUIB effectively protected the graft from complete failure despite significant trauma. Additionally, suture tape reinforcement using the MUIB technique improves outcomes in revision ACL reconstructions by preventing graft elongation, tunnel widening, and stress shielding while also providing protective reinforcement.

Abstract   |   Reference

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About Us

The Malaysian Orthopaedic Journal is a peer-reviewed journal that is published three times a year in both print and electronic online version. The purpose of this journal is to publish original research studies, evaluation of current practices and case reports in various subspecialties of orthopaedics and traumatology, as well as associated fields like basic science, biomedical engineering, rehabilitation medicine and nursing.

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