AperFix versus TransFix in Reconstruction of Anterior Cruciate Ligament

Üzümcügil, Onat; Doğan, Ahmet; Dalyaman, Erhan; Yalçınkaya, Merter; Akman, Yunus Emre; Öztürkmen, Yusuf; Caniklioglu, Mustafa

doi:10.1055/s-0030-1262904

Cited by 13 publications

(14 citation statements)

References 13 publications

(24 reference statements)

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“…Clinically, the involved knees did as well as those in other stud-ies in the literature with regard to postoperative Lysholm scores, ROM, and other parameters. [7][8][9][10] To the authors' knowledge, one other report exists on the outcome of the AperFix System for ACL reconstruction. Uzumcugil et al 9 compared the outcomes of the TransFix fixation method (Arthrex Inc, Naples, Florida) and the AperFix System after arthroscopic ACL reconstruction.…”

Section: Discussionmentioning

confidence: 99%

“…The investigators concluded that the AperFix System had a satisfactory performance comparable with that of cross-pin fixation. 9 Three additional clinical studies report on the AperFix System. Cooper et al 11 described the successful removal of AperFix femoral and tibial components due to traumatic injury requiring a revision ACL procedure.…”

Section: Discussionmentioning

confidence: 99%

“…The degree of widening was not significantly different between implants except for smaller tibial tunnel diameter in the sagittal plane for the EndoButton compared with the other fixation types. 9 Tunnel widening has been recognized as a potential problem with certain types of fixation systems. 7,8,13,14 Possible causes of widening include heat necrosis from tunnel drilling, movement of the graft inside the tunnel, location of fixation points with respect to the articular surface, and nonspecific inflammatory response.…”

Section: Discussionmentioning

confidence: 99%

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Two-year Outcome With the AperFix System for ACL Reconstruction

Uribe¹,

Arango²,

Frank³

et al. 2013

Orthopedics

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The purpose of the study was to assess the fixation durability of the AperFix System (Cayenne Medical, Inc, Scottsdale, Arizona) used in arthroscopic reconstruction of the anterior cruciate ligament. The AperFix System consists of a femoral and tibial component designed to secure either allograft or autograft. The outcomes of 185 knees (180 patients) were retrospectively reviewed at a minimum of 2 years postoperatively. Mean age at surgery was 31±12 years (range, 16-68 years). Of these, a convenience sample was seen prospectively to obtain radiographs and to assess functional status. No cases occurred of fixation failure involving loss of graft positioning or pullout. No patients required revision anterior cruciate ligament reconstruction. In 2 knees, the tip of the central fixation pin had to be modified as a result of hardware prominence and soft tissue irritation at 434 and 159 days postoperatively, respectively. In 4 knees, tibial screw removal occurred secondary to local discomfort (mean, 239 days; range, 105-371 days). No other recurring adverse events or problems associated with the implants were identified. Forty-four patients were evaluated prospectively at a mean follow-up of 32±7 months. Lysholm scores and patient satisfaction scores were positively and significantly correlated with Tegner activity scores (r=0.61; P<.0001). Eighty-two (82%) patients had a KT-1000 (Medmetric Corp, San Diego, California) side-to-side difference of less than 3 mm (average, 0.4 mm). No indications of femoral device migration existed when comparing follow-up and immediate postoperative radiographs. The AperFix System provides durable femoral aperture fixation during anterior cruciate ligament reconstruction with excellent clinical outcome scores and a low complication rate.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Two-year Outcome With the AperFix System for ACL Reconstruction

Uribe¹,

Arango²,

Frank³

et al. 2013

Orthopedics

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“…23 However, few studies exist about the clinical behavior of this implant system. The only study addressing the clinical results of a PEEK polymer implant in ACL surgery was published recently by Uzumcugil et al 24 The study concluded that early clinical results with the AperFix implant system were satisfactory when compared with the cross-pin fixation in arthroscopy-assisted ACL reconstruction.…”

Section: Discussionmentioning

confidence: 99%

Effect of PEEK Polymer on Tunnel Widening After Hamstring ACL Reconstruction

Üzümcügil¹,

Yalçınkaya²,

Öztürkmen³

et al. 2012

Orthopedics

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The purpose of this study was to evaluate the effect of the AperFix device (Cayenne Medical, Inc, Scottsdale, Arizona), composed of polyetheretherketone (PEEK) polymer, on tunnel widening after hamstring anterior cruciate ligament (ACL) reconstruction as compared with 2 other fixation devices: the TransFix (Arthrex, Inc, Naples, Florida) and the EndoButton (Smith & Nephew Endoscopy, Mansfield, Massachusetts). Sixty-seven patients with isolated total ACL ruptures who underwent arthroscopically assisted reconstruction using hamstring autografts at the authors' institution were included in the study. Patients were assigned into 1 of 3 groups in a nonrandomized fashion: AperFix (n=18), TransFix (n=29), and EndoButton (n=20). Mean follow-up was 30 months. Tunnel widening measurements were performed on anteroposterior and lateral digital plain radiographs taken in postoperative week 1 and at final follow-up. Laxity testing, Lysholm scoring, and arthrometric evaluation were performed.All 3 graft fixation devices resulted in significant tunnel widening in both tibial and femoral tunnels at final follow-up when compared with the immediate postoperative period. Tunnel widening between groups was not significantly different in terms of coronal and sagittal femoral tunnel diameters. Tibial tunnel diameter increase in the sagittal plane in the EndoButton group was significantly smaller than that in the TransFix and AperFix groups. No correlation was found between the amount of tunnel enlargement and clinical outcomes of ACL surgery. This study's findings suggest that tunnel enlargement after ACL reconstruction is influenced by the type of graft fixation on the tibial side irrespective of clinical outcome, and PEEK polymer does not have an effect on tunnel widening after hamstring ACL reconstruction.

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“…It can also be characterized by a horizontal graft orientation and resorption of graft fibers, and is accompanied by a large joint effusion and lateral bone bruises.5.4 Evaluation of Tunnel Placement5.4.1 OverviewTo improve patient outcomes, much effort has been put towards determining the best method of placing ACL tunnels. Various studies have aimed at evaluating procedural modifications for the various reconstruction techniques to achieve more anatomical graft placements and more natural knee kinematics[142,146,[178][179][180][181].Very slight variations in tunnel placement can have dramatic effects on the success of the reconstruction[118,121,182]. For example, anterior misplacement of the femoral tunnel can result in knee instability and reduced flexion ability[118,165], and anterior misplacement of the tibial tunnel can result in graft impingement that is associated with decreased extension ability and graft abrasion[118,146,165].Burkart et al and Howell et al have reported variability between surgeons in tunnel placement[183,184].…”

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confidence: 99%

High throughput patient-specific orthopaedic analysis

Ramme¹

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Medical imaging technologies have allowed for in vivo evaluation of the human musculoskeletal system. With advances in both medical imaging and computing, patientspecific model development of anatomic structures is becoming a reality. Threedimensional surface models are useful for patient-specific measurements and finite element studies. Orthopaedics is closely tied to engineering in the analysis of injury mechanisms, design of implantable medical devices, and potentially in the prediction of injury. However, a disconnection exists between medical imaging and orthopaedic analysis; whereby, the ability to generate three-dimensional models from an imaging dataset is difficult, which has restricted its application to large patient populations. We have compiled image processing, image segmentation, and surface generation tools in a single software package catered specifically to image-based orthopaedic analysis. We have also optimized an automated segmentation technique to allow for high-throughput bone segmentation and developed algorithms that help to automate the cumbersome process of mesh generation in finite element analysis. We apply these tools to evaluate graft placement in anterior cruciate ligament reconstruction in a multicenter study that aims to improve the patient outcomes of those that undergo this procedure.

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AperFix versus TransFix in Reconstruction of Anterior Cruciate Ligament

Cited by 13 publications

References 13 publications

Two-year Outcome With the AperFix System for ACL Reconstruction

Two-year Outcome With the AperFix System for ACL Reconstruction

Effect of PEEK Polymer on Tunnel Widening After Hamstring ACL Reconstruction

High throughput patient-specific orthopaedic analysis

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