Bioabsorbable versus metallic interference screws for graft fixation in anterior cruciate ligament reconstruction

Abstract

Background Anterior cruciate ligament (ACL) tears are frequently treated with surgical reconstruction with grafts, frequently patella tendon or hamstrings. Interference screws are often used to secure the graft in bone tunnels in the femur and tibia. This review examines whether bioabsorbable interference screws give better results than metal interference screws when used for graft fixation in ACL reconstruction. Objectives To assess the effects (benefits and harms) of bioabsorbable versus metallic interference screws for graft fixation in ACL reconstruction. Search methods We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, CENTRAL (the Cochrane Library), MEDLINE, Embase, LILACS, trial registers and reference lists of articles. Date of search: January 2016. Selection criteria We included randomised controlled trials and quasi-randomised trials comparing bioabsorbable with metallic interferences screws in ACL reconstruction. The main outcomes sought were subjective-rated knee function, failure of treatment, and activity level. Data collection and analysis At least two review authors selected eligible trials, independently assessed risk of bias, and cross-checked data. Data were pooled whenever relevant and possible. Requests for further information were sent to the original study authors. Main results We included 12 trials (11 randomised and one quasi-randomised) involving a total of 944 participants, and reporting follow-up results for 774. Participants in the 12 trials underwent ACL reconstruction with either hamstring tendon grafts (five trials) or patellar tendon grafts (seven trials). Trials participants were randomly allocated to bioabsorbable or metallic interference screws for graft fixation in Bioabsorbable versus metallic interference screws for graft fixation in anterior cruciate ligament reconstruction (Review)

Is all-inside with suspensory cortical button fixation a superior technique for anterior cruciate ligament reconstruction surgery? A systematic review and meta-analysis

“…More studies investigating the long-term follow-up were needed to prove the reliability of this new technique and implants. Third, although the bioabsorbable interference screw has been frequently used in ACLR [ 27 , 28 ] and was selected as a control technique in our selected studies, other graft fixation methods are still available, such as metallic interference screw, cross-pin, and staple fixation, which have played roles in current ACLR surgery. However, there is a lack of evidence to compare these techniques or implant fixation to the all-inside technique, and thus, it is hard to determine the optimal method.…”

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“…The anterior cruciate ligament (ACL) is a band of tough tissue inside the knee that helps stabilise the knee during movement. Rupture of the ACL is a common injury during some sporting activities, such as football and skiing , Debieux P., Franciozi CES, Lenza M., Tamaoki M.J., Magnussen R.A., Faloppa F., Belloti J.C. , 2016 .…”

Advances and Challenges of Biodegradable Implant Materials with a Focus on Magnesium-Alloys and Bacterial Infections

“…Even though they may act somewhat inflammatory compared to metals, biodegradable polymeric implants have been routinely employed as suture material and to temporarily fix tendons to bones until they eventually adhere by themselves [37,38]. Popular hydrolysable polymers used for bioresorbable scaffolds are poly(lactic-co-glycolic) acid (PLGA), polylactic acid (PLA) or polyglycolic acid (PGA) [39].…”