Comparing Bridge-Enhanced Anterior Cruciate Ligament Repair to Standard Autograft for Anterior Cruciate Ligament Reconstruction: Biomechanical and Clinical Outcomes.

INTRODUCTION: Bridge-enhanced anterior cruciate ligament (BEAR) repair has emerged as a biologic alternative to conventional autograft anterior cruciate ligament reconstruction (ACLR), aiming to preserve native ligament tissue while restoring knee stability. This paper compared the biomechanical and clinical outcomes of BEAR repair with standard autograft ACLR. MATERIALS AND METHODS: A comparative observational study was conducted in the Department of Orthopedics. Patients with complete anterior cruciate ligament (ACL) tears who underwent either BEAR repair or standard autograft ACLR were included. Demographic characteristics, functional outcomes (International Knee Documentation Committee [IKDC], Knee Injury and Osteoarthritis Outcome Score [KOOS], Lysholm, Tegner scores), knee stability, muscle strength recovery, return-to-sport, and post-operative complications were evaluated. Statistical analysis was performed using the Statistical Package for the Social Sciences version 27.0, and a P < 0.05 was considered statistically significant. RESULTS: Baseline demographic characteristics were comparable between the two groups (P > 0.05). Functional outcome scores, including IKDC, KOOS, Lysholm, and Tegner scores, showed no statistically significant differences between BEAR and autograft ACLR (P > 0.05). Knee stability parameters and magnetic resonance imaging healing rates were also comparable. However, patients undergoing BEAR repair demonstrated significantly greater quadriceps strength recovery (95.2 ± 5.3% vs. 92.6 ± 6.1%; P = 0.04), hamstring strength recovery (97.4 ± 4.2% vs. 86.8 ± 7.5%; P < 0.001), and earlier recovery of full muscle strength (8.3 ± 1.4 vs. 9.6 ± 1.8 months; P = 0.01). Return-to-sport rates and post-operative complication rates were similar between both groups. CONCLUSION: BEAR repair provides clinical and biomechanical outcomes comparable to standard autograft ACLR while offering significantly better post-operative muscle strength recovery. It represents an effective treatment option for appropriately selected patients with acute ACL injuries.