Bioabsorbable interference screw versus bioabsorbable cross pins: influence of femoral graft fixation on the clinical outcome after ACL reconstruction

Abstract

PurposeThe aim of this study was to evaluate the clinical outcome and differences in anterior–posterior laxity of ACL reconstruction using a bioabsorbable interference screw for femoral graft fixation when compared to femoral bioabsorbable cross pin fixation.MethodsClinical outcome was evaluated among 59 patients 1 year after arthroscopic ACL reconstruction with hamstrings graft in a prospective, non-randomised study. In 31 cases, femoral fixation of the graft was performed using a bioabsorbable interference screw. In 28 cases, two bioabsorbable cross pins were used for femoral fixation. Patients were evaluated using Tegner, Lysholm and Marshall scores, the visual analogue scale for pain and KT-1000 arthrometer measurement.ResultsNo significant difference (P ≥ 0.05) was observed at follow-up for the knee scores. The average Tegner score was 5.83 points (±2.00) for the interference screw fixation and 5.83 points (±1.24) for the cross pin fixation; the average Lysholm score was 93.58 (±5.79) to 92.72 (±6.34) points; and the average Marshall score 46.72 (±2.4) to 47.30 (±2.35) points. No significant difference was found for the visual analogue scale for pain. KT-1000 arthrometer measurement revealed a significant (P < 0.05) difference in the mean side-to-side anterior translation at all applied forces. At 67 N, the mean difference was 1.53 mm (±1.24) in the interference screw group and 0.47 mm (±1.18) in the cross pin group (P < 0.05). At 89 N, the mean differences were 1.85 mm (±1.29) versus 0.59 mm (±1.59), respectively, (P < 0.05), and maximum manual displacements were 2.02 mm (±1.26) versus 1.22 mm (1.18; P < 0.05).ConclusionsIn ACL reconstruction with hamstrings graft, similar clinical results are obtained for the use of bioabsorbable cross pins when compared to bioabsorbable interference screws for femoral fixation. Cross pin fixation was superior with regard to the anteroposterior laxity as measured with KT-1000.

Graft fixation influences revision risk after ACL reconstruction with hamstring tendon autografts

“…Frosch et al. ( 2012 ) compared, in a prospective non-randomized study, femoral fixation with bioabsorbable interference screws in 31 cases and bioabsorbable Rigidfix in 28 cases. They found similar subjective results but less side-to-side anterior translation as measured with a KT-1000 arthrometer in the cases with femoral fixation using Rigidfix.…”

Arthroscopic ACL reconstruction using patellar bone tendon autograft and Rigidfix fixation - A midterm functional outcome

“…They could eliminate anterior tibial translation in 93.1% of patients. There is also a recent study by Stephan Frosch et al 32 on 2012 which reported similar functional outcome when they used femoral bioabsorbable cross pin for femoral fixation of hamstrings graft at one year follow up.…”

Comparison of Outcomes of Two Femoral Fixation Devices in Hamstring Anterior Cruciate Ligament Reconstruction

“…Cortical-cancellous as well as cortical suspension techniques have shown good clinical results and primary stability after ACL reconstruction. 5 11 12 13 …”

“…In agreement with the previous, Frosch et al . 13 published a prospective nonrandomized study comparing cross-pin femoral fixation with bioabsorbable interference screw fixation in hamstring ACL reconstruction. They also found similar clinical results between the two groups.…”