Excellent 2‐Year Outcomes of MUIB All‐Inside ACL Reconstruction: A Registry‐Based Analysis of 63 Patients With Zero Graft Failure

BACKGROUND: Anterior cruciate ligament reconstruction (ACLR) remains a cornerstone of orthopedic sports medicine, yet graft failure rates are high despite advances in surgical techniques. The Modified UKM 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 and 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). There were no statistically significant differences observed between allograft and autograft groups across all outcome measures, suggesting that the MUIB technique may yield comparable outcomes regardless of graft type. 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. CONCLUSION: The MUIB all-inside ACLR technique yielded excellent 2-year outcomes in this cohort, characterized by a zero graft failure rate, complete pain resolution, and exceptional functional recovery. However, given the retrospective, uncontrolled design, these findings should be interpreted as preliminary and hypothesis-generating. Prospective comparative studies are necessary to establish the efficacy and potential superiority of the MUIB technique relative to conventional ACLR approaches.