Rigid-fix Pins fixation and LCA reconstruction with semitendinosus/gracilis autograft

Abstract

ACL reconstruction techniques highly developed during the decades and biomechanical tests for hamstrings graft showed much in advance loading and stiffness comparing BPTB grafting. We have made joint analysis of 30 patients with semitendinosus / gracilis ACL reconstruction. Choice for proximal fixation was Mitek Rigid-fix Pins technique and bioactive screws for distal fixation; in 18 cases bioactive screws were used for femoral and tibial graft fixation. Lysholm score and knee clinical tests were parameters used for outcome evaluation. Follow up averaged 6 months with assessment after 1, 3, 6 and 12 months. Our results showed excellent postoperative Lysholm score in 85% and very good in 15% of cases. Postoperative Lachman was 1+ in 15% and postoperative pivot shift was 0%. Full rehabilitation achieved 85% and with modifications in everyday activities 15% of patients. Donor localization morbidity was markedly reduced and we have no complications. On the basis of the improved results in graft compression as well as stability with this technique, applied method is highly recommended for the reconstruction in ACL deficient knees.

ACL reconstruction using femoral Rigid-fix and tibial Bio-intrafix devices

“…[21][22][23] Numerous studies have evaluated the clinical outcome of rigid fix technique in ACL reconstruction and some studies have compared this method of fixation with others to have a definite conclusion. 10,12 While comparing the Rigid-fix (n = 71) and PINN ACL cross pin techniques (n = 56) in 127 patients (N), Seo et al 10 did not observe any statistical difference in IKDC score and Lysholm score; however, 5 cases (7%) in rigid fix group and 40 cases (71%) in PINN ACL cross pin group were found to be associated with perioperative complications with statistical difference (p < 0.0001). They concluded that there was no resultant difference between the employment of PINN-ACL Cross Pin and Rigid-fix as femoral graft fixation for ACL reconstruction with hamstring tendon.…”

“…2 Expansion fixation that is based on pressfit fixation of a graft into the femoral tunnel by employing more than one cross pin has been reported to render satisfying results in biomechanical and clinical studies. 10,12,14,19 This fixation provides secure fixation to the graft as the cross pins applied transversely through the graft, imparts a centrifugal pressure on the femoral tunnel. Nevertheless, the treatment results depend on the press-fit of the graft, bone density around the femoral tunnel, and correct placement of the cross pins through the graft tendon.…”

“…The femoral rigid-fix cross-pin and tibial bio-intrafix fixations are technically simple and reproducible. 9,10,12,13,16,18,19 We believe that both experienced and inexperienced surgeons can fix the soft tissue graft with these devices without peroperative hurdles. Certain technical tricks definitely helped us in avoiding intraoperative hurdles.…”

“…They concluded that centrally placed polyethylene screw with sheath provided equivalent clinical outcomes to that of interference screw and staples at minimum 2-year follow-up. Wang et al 16 Blagojevi et al 12 described their result of ACL reconstruction in 30 patients. The Mitek rigid fix pins were used for femoral tunnel where as bio-absorbable screws were used for the tibial tunnel.…”

“…Several biomechanical and clinical studies have shown that femoral cross-pin and tibial Intrafix or Bio-intrafix devices provide increased strength and stiffness to the graft fixation. 2,[9][10][11][12][13][14][15][16][17][18][19] In this study, we evaluate the clinical and functional outcomes of the knee joint after ACL reconstruction with hamstring graft, fixed with femoral cross pin (Rigid-fix) and tibial Bio-intrafix devices.…”