Comparative Results of Anterior Cruciate Ligament Reconstruction with Full Tibial Tunnel: Quadrupled Semitendinosus Suspensory Femoral and Tibial Fixation versus Quadrupled Semitendinosus and Gracilis Suspensory Femoral and Tibial Screw and Staple Fixation

Abstract

This study compared the clinical outcomes of patients treated with described “modified all-inside” anterior cruciate ligament reconstruction (ACLR) technique with those of patients treated with suspensory femoral fixation and a bioabsorbable tibial interference screw with the ACLR technique. From 2017 to 2019, 98 patients who underwent ACLR surgery by two surgeons using either of the techniques were included in this study. Patients in group 1 were treated with the “modified all-inside” ACLR technique. In this technique, only the semitendinosus tendon was harvested as a four-strand graft and fixed to the tibia and femur with suspensory buttons. Patients in group 2 were treated with suspensory femoral fixation and a bioabsorbable tibial interference screw ACL reconstruction technique. Patients' functional outcomes were evaluated by the Lysholm score, Tegner activity scale, and International Knee Documentation Committee (IKDC) subjective score. Postoperative knee stability of the patients was evaluated using the Lachman test and the pivot-shift test. The mean ages of the patients were 31.1 (16–55) and 28.7 (18–48) years in groups 1 and 2, respectively. The average follow-up durations were 26 (20–30) and 25.9 (22–30) months for both groups. There was no significant difference between the preoperative and postoperative Lysholm's score, Tegner's activity score, and IKDC subjective score in groups 1 and 2. There were no major complications or reruptures in either group. ACLR incorporating the “modified all-inside” ACLR technique obtained significant clinical outcomes compared to ACLR with a suspensory femoral fixation and a bioabsorbable tibial interference screw.

Evaluation of Isokinetic Knee Strengths after ACL Reconstruction with Quadrupled Semitendinosus Suspensory Femoral and Tibial Fixation versus Four-Strand Semitendinosus and Gracilis Suspensory Femoral and Tibial Screw Fixation

“…The autograft was then attached to the femoral socket with a suspensory device and to the tibial socket with an expanded suspensory device. This fixation technique provides adequate stability for tendon autograft [ 19 ].…”

“…Both tunnels were drilled in an antegrade fashion, and the diameters were adjusted according to autograft thickness. Autografts were fixed femoral and tibial tunnels with suspensory fixation device combinations [ 19 ].…”

The Relationship between Lower Extremity Functional Performance and Balance after Anterior Cruciate Ligament Reconstruction: Results of Patients Treated with the Modified All-Inside Technique

“…Graft tightness was then examined with a probe. Finally, the entire structure was re-tensioned on the tibial side, and an additional ligation was made on the adjustable suspension fixation device using a non-slip knot [ 6 ]. Figure 2 shows intraoperative fixation.…”

“…In addition, the so-called “all-inside” technique, with only ST and fourfold (4ST) grafting, has become widespread recently [ 5 ]. The all-inside technique has many advantages, but the modified all-inside (MAI) technique was developed by Mahirogullari et al [ 6 ] due to the need to use a special drill while creating the socket, the problem of adjusting the socket depth, and the high cost of the all-inside technique [ 7 , 8 ]. In the MAI technique, the ST graft, prepared by folding the ST tendon four times, is fixed to the tibia and femur with a suspended suspension [ 9 ].…”

Does Rotation and Anterior Translation Persist as Residual Instability in the Knee after Anterior Cruciate Ligament Reconstruction? (Evaluation of Coronal Lateral Collateral Ligament Sign, Tibial Rotation, and Translation Measurements in Postoperative MRI)

“…After obtaining approval from the Institutional Review Board (SÜKAEK-2023 6/17), a retrospective analysis was conducted on patients aged 18 years and older who underwent isolated anterior cruciate ligament reconstruction between December 2019 and December 2021. To standardize this study, patients who underwent ACL reconstruction with the same technique (anatomical reconstruction with adjustable suspensory fixation system) [24], performed by a single surgeon (LK) with over 400 cases of ACL reconstructions experience annually, were included in this study. The other inclusion criteria were set as follows: the time between ACL rupture and surgery being 6 months, availability of preoperative (preop) and postoperative (postop) clinical scores (Lysholm knee scoring scale (LKSS), Tegner activity score (TAS), International Knee Documentation Committee score (IKDC)), and objective determination of muscle strength using isokinetic dynamometer device measurements.…”