Comparison of Outcomes of Two Femoral Fixation Devices in Hamstring Anterior Cruciate Ligament Reconstruction

Abstract

Background:Tear of the anterior cruciate ligament (ACL) is a common ligamentous injury of the knee. Reconstruction of this ligament is often required to restore functional stability of the knee. Outcome of ACL reconstruction is significantly affected by how the graft is fixed to the bone. This study is to determine if there is a different clinical outcome after cortical versus cortical-cancellous suspension femoral fixation in hamstring based anterior cruciate ligament (ACL) reconstruction.Materials and Methods:This is a retrospective comparative study conducted between 2006 and 2010. We enrolled patients who underwent arthroscopic ACL reconstruction. Sixty two patients met inclusion criteria and 41 agreed to come for followup assessment. Median age was of 28 years (range 18–39 years). Demographic baseline profile of both groups was similar. The femoral fixation devices were cortical (n = 16) and cortical-cancellous suspension techniques (n = 25). The average period of evolution at the time of assessment was 40 months (range 12-72 months). The patients were examined according to Lachman test (using Rolimeter knee tester), anterior drawer test, pivot shift test, International Knee Documentation Committee questionnaire, and Tegner-Lysholm knee scoring scale.Results:The objective evaluation of the patients (Lachman test) showed better results in terms of stability in the group of patients who underwent the cortical-cancellous suspension method. These differences were not reflected in the assessment of activity level (Tegner-Lysholm), where both groups showed the same results.Conclusions:ACL reconstruction with both cortical and cortical-cancellous suspension femoral fixation techniques show the same clinical results at medium long followup. However, cortical-cancellous fixations seem to provide greater stability to the reconstruction.

The accuracy of MRI in the diagnosis of anterior cruciate ligament injury

“…The ACL originates at the front of the inter-ankle carina of the tibia, slants backward, outward, and upward, and terminates at the medial and posterior sides of the lateral femoral malleolus. The functions of the ACL include restricting excessive forward movement of the tibia, hyperextension of the knee joint, rotation of the tibia, and knee extension (7,8). The ACL is at a special position in the knee joint, with highest vulnerability of all its parts.…”

Upsurge of Sports Injuries and Their Treatment

“…However, cortical-cancellous fixations seem to provide greater stability to the reconstruction. 7 ACL reconstruction is mostly considered a safe and reproducible technique. However, there remains an underlying rate of failure to return to preinjury sporting activity levels, and in these cases, postoperative laxity and graft re-injury remain a cause of concern.…”