Methods and devices for graft fixation in anterior cruciate ligament reconstruction

Zeng, Chao; Lei, Guanghua; Gao, Shu‐guang; Luo, Wei

doi:10.1002/14651858.cd010730

Cited by 20 publications

(14 citation statements)

References 31 publications

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“…However, potential disadvantages of this fixation method include divergent screw placement, difficulties with removal during revision surgery, and the risk of graft damage [58,110,111]. Among the various BTB graft fixation methods, including metallic or bioresorbable interference screws, cortical suspensory graft fixation devices, post screws, and buttons, interference screws have been used the most widely.…”

Section: Graft Fixationmentioning

confidence: 99%

ACL Injury and Its Treatment

Ochi¹,

Shino²,

Yasuda³

et al. 2016

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Section: Graft Fixationmentioning

confidence: 99%

ACL Injury and Its Treatment

Ochi¹,

Shino²,

Yasuda³

et al. 2016

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“…There are two types of titanium buttons in use: one with a fixed-length loop and the other with an intraoperative adjustable-length loop. 7 This study presents a comparative analysis of results after ACLR using two implant types for suspensory graft fixation in the femoral tunnel. The ACLR in all subjects included in the study was performed using a quadruple semitendinosus-gracilis (STG) graft with two types of suspensory fixation on the lateral femoral cortex, whereas the graft fixation in the tibial tunnel was performed using an osteoconductive bioresorbable screw.…”

Section: Abstract Introductionmentioning

confidence: 99%

Application of two types of suspensory fixation in reconstruction of anterior cruciate ligament with a semitendinosus-gracilis graft: A randomized prospective study

Djordjevic¹,

Petrović²,

Zuncic-Djordjevic

et al. 2021

VOJNOSANIT PREGL

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Injury to the anterior cruciate ligament (ACL) of the knee is the most common ligament injury that requires operative treatment. Patient treatment can be non-operative and operative. So far, multiple ACL reconstruction (ACLR) techniques using a variety of graft types and implants that fixate the grafts have been described. Since 1995, titanium buttons with a loop have been used as implants for suspensory fixation of the graft in the femoral tunnel during ACLR. There are two types of titanium buttons in use: one with a fixedlength loop and the other with an intraoperative adjustable-length loop. This randomized prospective study presents a comparative analysis of results after ACLR using two implant types for suspensory graft fixation in the femoral tunnel. The post-operative knee stability was assessed 24 months after surgery using the Lachman test and the lateral pivot shift test, as well as the KT-1000 arthrometer test. In patients whose graft was fixated using a fixedlength loop implant, the mean post-surgery knee stability, measured with the KT-1000, was 1.167 +/-0.780; in patients whose graft was fixated using an adjustable-length loop implant, the mean value was 1.100+/-0.894 (P=0.605). The mean post-surgery IKDC score for the fixed-length loop group was 84.887 +/-9.0207, while for the adjustable-length loop the score was 88.327 (+/-7.302). The mean Lysholm score was 93.50+/-6.872 for the fixedlength loop group of patients and 94.00 +/-5.527 for the adjustable-length loop group. The results of this study lead to a conclusion that both types of implants can be used with success during ACLR, because the functional results of operative treatment using both implants were identical after surgery.

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“…Devices for tibial fixation can be divided according to the location of fixation: intratunnel fixation and extratunnel fixation. Intratunnel fixation methods primarily rely on interference screw (metallic or bioabsorbable) or a cross pin system [16] . The aperture fixation methods like the interference screws allows for early firm fixation and heal with tight bone-tendon interface [17,18] .…”

Section: Introductionmentioning

confidence: 99%

A prospective study of functional outcome of ACL reconstruction with quadrupled semitendinosus tendon autograft using Endobutton and bioabsorbable interference screw

Mishra¹,

Girish²

2018

Int. J. Orthop. Sci.

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Background: The Anterior Cruciate ligament (ACL) is the primary stabilizer of the knee and prevents the knee against anterior translation. It is also important in counteracting rotational and valgus stress. Anterior Cruciate Ligament (ACL) reconstruction is an established and widely practiced surgical procedure with proven efficacy and a low morbidity profile. The arthroscopically aided approach has the advantages of smaller skin and capsular incisions, improved viewing of the intercondylar notch for placement of the tunnel and attachment sites, less postoperative pain, fewer adhesions, earlier motion, and easier rehabilitation. The advantages with semitendinosus grafts are availability of a greater sectional area and unaffected integrity of the extensor mechanism. Moreover tensile strength of quadrupled hamstring is found to be even better than a normal ACL. The rate of complications like extension loss, anterior knee pain and surgical site infections was also lower than other procedures like in BPTB grafts. Cortical suspension devices have the necessary biomechanical properties with regard to ultimate failure strength, displacement, and stiffness for initial fixation of soft tissue in the femoral tunnel for ACL reconstruction. The aperture fixation methods like the interference screws allows for early firm fixation and heal with tight bone-tendon interface. Objectives: To evaluate functional outcome of arthroscopy assisted ACL reconstruction with quadrupled semitendinosus tendon graft using Endobutton and Bioabsorbable interference screw. Methodology: The study results included 120 patients (serving soldiers) admitted with clinical and radiological deficiency of ACL during march 2015 to march 2018, in Department of Orthopaedics, Armed Forces Medical College, Pune. Study aims to assess the functional outcome of arthroscopy assisted anterior cruciate ligament reconstruction with quadrupled semitendinosus tendon graft using Endobutton and Bioabsorbable interference screw in terms of range of motion, postoperative knee stability, graft site morbidity, subjective knee functions and prospective assessment of functional outcome using Tegner Lysholm knee scoring system. Results: All the patients included in the study were serving male soldiers. The analysis of the studied cases revealed that the most common affected age group was between 18 to 24 years (n=41, 34.2%) and the mean age was 30.53 ± 7.24 years. Majority of patients (n=76, 64.4%) were operated more than 6 months after injury. Sports/BPET (Battle Physical Efficiency Test) injuries was the most common mode of injury (n=79, 65.8%). The mean size of graft used was 8.2±0.39.Post-operatively at 02 year follow up, 08 case (6.7%) had a positive Pivot shift test with a "Glide" (Grade-I), whereas remaining 112 cases (93.3%) had a negative Pivot shift test. None of the patients had grade III laxity. The mean postoperative rolimeter measurement at 02 year follow up was 3.86±1.06 SD. The mean postoperative Lysholm score improved from pre-operative score of 66±5....

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Methods and devices for graft fixation in anterior cruciate ligament reconstruction

Cited by 20 publications

References 31 publications

ACL Injury and Its Treatment

ACL Injury and Its Treatment

Application of two types of suspensory fixation in reconstruction of anterior cruciate ligament with a semitendinosus-gracilis graft: A randomized prospective study

A prospective study of functional outcome of ACL reconstruction with quadrupled semitendinosus tendon autograft using Endobutton and bioabsorbable interference screw

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