Complications of the Screw/Washer Tibial Fixation Technique for Knee Ligament Reconstruction

Almeida, Alexandre; Roveda, Gilberto; Valin, Márcio Rangel; Almeida, Nayvaldo Couto de; Sartor, Vanderlei; Alves, Soraya Melina

doi:10.1016/s2255-4971(15)30428-6

Cited by 4 publications

(4 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…To prevent knee stiffness, inflammation control and early knee motion are generally advised [ 38 ]. Postoperative knee pain and function impairment can also be due to hardware intolerance [ 39 ]. In the present systematic review, a total of 26 cases (15.2%) required a second surgical procedure to remove fixation hardware.…”

Section: Discussionmentioning

confidence: 99%

Management and Outcomes of Tibial Eminence Fractures in the Pediatric Population: A Systematic Review

et al. 2023

View full text Add to dashboard Cite

Background: Tibial eminence fractures (TEF) of Meyers–McKeever type II-III-IV usually require surgical management. No consensus in the literature has been achieved regarding the best treatment option. The aims of the present systematic review were (1) to analyze the current literature and describe the outcomes of surgical treatment for TEF; and (2) to compare the outcomes of different surgical options using arthroscopic reduction and internal fixation (ARIF) with sutures or screws and open reduction and internal fixation (ORIF). Methods: A search was carried out with Pubmed, Medline, and Cochrane. Key terms were used “tibial” AND “eminence” or “spine” or “intercondylar” AND “paediatric” or “children” AND “fracture” or “avulsion” AND “treatment”. Twelve articles met the inclusion criteria. Demographic data, clinical outcomes, and complication rates were evaluated for each study. Means/standard deviation and sum/percentage were used for continuous and categorical variables, respectively. Chi-square or t-student tests were applied. A p-value < 0.05 was considered statistically significant. Results: ORIF showed superior clinical outcomes (Tegner (p < 0.05) and Lysholm (p < 0.001) scores) relative to ARIF and a lower incidence of arthrofibrosis (p < 0.05) and implant removal (p < 0.01). The Tegner, IKDC, and Lysholm scores showed statistically significant superior results following arthroscopic sutures compared to arthroscopic screws (p < 0.001). The incidence of arthrofibrosis was higher after arthroscopic sutures (p < 0.05), the implant removal was higher after screw fixation (p < 0.001) Conclusions: Better clinical results with low complication rates were achieved with ORIF surgery rather than ARIF; arthroscopic suture fixation resulted in higher clinical results compared to arthroscopic screw fixation and reduced the incidence of postoperative complications.

show abstract

Section: Discussionmentioning

confidence: 99%

Management and Outcomes of Tibial Eminence Fractures in the Pediatric Population: A Systematic Review

et al. 2023

View full text Add to dashboard Cite

show abstract

“…In a study by Almeida et al they demonstrated a 10.8% rate of hardware removal in patients who had a screw and washer construct on the tibial side for fixation. 39 Another study in which the surgeon used primarily interference screws for fixation on the tibial side, demonstrated the rate of hardware removal at about 5%. 40 Our findings were more like these two studies as compared to the previously cited reoperation studies.…”

Section: Discussionmentioning

confidence: 99%

Risk of reoperation after primary anterior cruciate ligament reconstruction in children and adolescents

Nester

Torino

Sylvestre

et al. 2022

J Orthop Surg (Hong Kong)

View full text Add to dashboard Cite

Objective To examine the incidence and risk factors of any-cause reoperation after primary ACLR in children and adolescents. Design Retrospective Cohort Setting Electronic medical records from a large tertiary care, single institution integrated healthcare delivery system. Patients Patients were under the age of 18 years and had anterior cruciate ligament reconstruction. They were excluded if they had a multi-ligamentous knee injury or <1 year follow-up. Interventions Patients were further identified to have undergone a subsequent knee operation ipsilaterally or contralateral ACLR. Main outcome measures The rate of any-cause reoperation was our primary outcome measure. Results The median age was 16. There were 208 females (53.9%) and 178 males (46.1%) included. The median follow-up was 25 months with a minimum of 12 months (interquartile range: 16.0, 46.0). The rate of any-cause reoperation was 34.7%. There was no statistically significant difference between those who underwent reoperation versus those who did not undergo reoperation relative to age, sex, BMI, graft type, or the presence of concomitant meniscal injury. The rates of ipsilateral ACLR and contralateral ACLR at any time during the study period was 8.0% and 10.9% respectively. There was no statistically significant difference for rate of reoperation between graft types, between various concomitant injuries, between those who underwent meniscus repair or no repair. Conclusions This study reflects a 34.7% rate of a subsequent knee operation after ACLR in patients younger than 18 years. These findings can be used to inform pediatric patients undergoing primary ACLR on their risk of returning to the operating room.

show abstract

“…13 The tibial grafts are usually fixed with interference screws 14,15 as they were easy to place, however the tibial interference screws sometimes have complications such as slippage and cysts. [16][17][18][19][20] U-staple is another commonly used fixation device for the tibial tunnel, but it has a significant increase in the risk of symptomatic hardware causing pain on kneeling. 14 The all-inside technique has also been widely introduced for ACL reconstruction with an adjustable-loop button for tibial side fixation, but there is still controversy regarding undesired lengthening of adjustable-loop devices.…”

Section: Introductionmentioning

confidence: 99%

“…This is especially true for the tibial graft fixation, which has been considered the weakest link of the reconstruction 12 due to the lower density of the tibial bone and the parallel graft‐fixation associated with the tunnel 13 . The tibial grafts are usually fixed with interference screws 14,15 as they were easy to place, however the tibial interference screws sometimes have complications such as slippage and cysts 16–20 . U‐staple is another commonly used fixation device for the tibial tunnel, but it has a significant increase in the risk of symptomatic hardware causing pain on kneeling 14 .…”

Section: Introductionmentioning

confidence: 99%

Outcomes of RigidFix Cross Pin Fixation in Femoral and Tibial Tunnel for Anterior Cruciate Ligament Reconstruction

Yuan,

Qi,

et al. 2023

Orthopaedic Surgery

View full text Add to dashboard Cite

ObjectivesThere is no clear consensus so far on which fixation method is most favorable for the tibial tunnel in anterior cruciate ligament reconstruction (ACLR). The purpose of this paper is to investigate the outcome of RigidFix cross pins fixation in the tibial tunnel and to explore the advantages of RigidFix applied both in the femoral and tibial tunnel with hamstring tendon graft in anterior cruciate ligament reconstruction.MethodsThis retrospective study included 53 patients (male/female, 45/8) who underwent anterior cruciate ligament reconstruction using autologous hamstring tendons between January 2013 and December 2017 at our institute. The participants in group A (n = 36) received anterior cruciate ligament reconstruction with RigidFix cross pins fixation in both femoral and tibial tunnels, while those in group B (n = 17) with RigidFix cross pins fixation in the femoral tunnel and Interference screw fixation in the tibial tunnel. The visual analogue scale (VAS) score, International Knee Documentation Committee subjective knee form 2000 (IKDC2000) score, Lysholm knee scoring scale, Tegner activity score and the side‐to‐side difference were compared at 2 and 5 years postoperatively. The graft diameter, number of strands in graft and the average diameter of each strand were also compared between the two groups. The categorical parameters were analyzed by chi‐square test and the continuous variables conforming to a normal distribution were analyzed by Student's t‐test.ResultsAt 2 years postoperation, the VAS score (1.61 ± 0.55), side‐to‐side difference (1.50 ± 0.58) in group A were significantly lower than that in group B, and the IKDC2000 score (88.81 ± 3.88), Tegner activity score (6.14 ± 0.60) in group A were significantly higher than that in group B. At 5 years postoperation, the VAS score (1.64 ± 0.68), side‐to‐side difference (1.73 ± 0.63) in group A were significantly lower than that in group B, and the IKDC2000 score (89.09 ± 3.85), Tegner activity score (6.58 ± 0.94) in group A were slso significantly higher than that in group B. There was statistical difference in the change of the side‐to‐side difference between the two groups (group A vs. B, 0.22 ± 0.08 vs. 0.34 ± 0.11, p < 0.001). There were also statistical differences in the graft diameter (group A vs. B, 7.83 ± 0.74 vs. 7.41 ± 0.51, p = 0,038), number of strands in graft (5.67 ± 0.72 vs. 4.00 ± 0.00, p < 0.001) and the average diameter of each strand (1.41 ± 0.22 vs. 1.85 ± 0.13, p < 0.001) between the two groups.ConclusionRigidFix cross pins fixation in the tibial tunnel for anterior cruciate ligament reconstruction can achieve better 5‐year results when compared with the interference screw, and the hamstring tendon can be folded into a thicker graft when RigidFix cross pins were applied in both femoral and tibial tunnels.

show abstract

Complications of the Screw/Washer Tibial Fixation Technique for Knee Ligament Reconstruction

Cited by 4 publications

References 33 publications

Management and Outcomes of Tibial Eminence Fractures in the Pediatric Population: A Systematic Review

Management and Outcomes of Tibial Eminence Fractures in the Pediatric Population: A Systematic Review

Risk of reoperation after primary anterior cruciate ligament reconstruction in children and adolescents

Outcomes of RigidFix Cross Pin Fixation in Femoral and Tibial Tunnel for Anterior Cruciate Ligament Reconstruction

Contact Info

Product

Resources

About