In vivo comparison of a fixed loop (EndoButton CL) with an adjustable loop (TightRope RT) device for femoral fixation of the graft in ACL reconstruction: A prospective randomized study and a literature review

Ranjan, Rahul; Gaba, Sahil; Goel, Lakshay; Asif, Naiyer; Kalra, Mukesh; Kumar, Rajeev; Kumar, Arvind

doi:10.1177/2309499018799787

Cited by 16 publications

(35 citation statements)

References 17 publications

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“…reported equivalent International Knee Documentation Committee, Lysholm scores, anterior translation, and side-to-side differences in their two year follow up study comparing EB and TR single bundle reconstruction. 16 Ahn et al. reported comparable graft healing assessed by MRI signal intensity at follow up as well as clinical results using RetroButton as a fixed-loop device.…”

Section: Discussionmentioning

confidence: 92%

“…Use of suspensory devices are popular in anterior cruciate ligament reconstructions (ACLR) when fixing soft graft material to the femoral side. 1 , 16 The devices consist of the combination of a small rectangular metal button that firmly contacts the cortex of the femur and a thread that connects the button and the graft. EndButton CL™ (EB, Smith & Nephew, Andover MA, USA) and Tightrope RT™ (TR, Arthrex, Naples FL, USA) are the two major devices used.…”

Section: Introductionmentioning

confidence: 99%

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Randomized comparative study of suspension femoral fixation device in graft position maintenance in anterior cruciate ligament reconstruction: EndoButton CL vs TightRope RT

Sato

Mukai

et al. 2021

Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilit

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Background In double-bundle anterior cruciate ligament reconstruction (ACLR), fixed-loop and adjustable-loop cortical suspensory devices are commonly used to fix the soft graft on the femoral side. However, few studies have compared in vivo elongation of the two devices. The purpose of this study was to determine whether EndoButton CL (EB) and TightRope RT (TR), the suspensory fixation devices used in ACLR, maintained their length in vivo from the time of surgery through the postoperative period in a randomized controlled trial. Methods This study prospectively incorporated 30 patients undergoing initial ACLR at a single center. Participants were divided into two groups using a stratified randomization method with age and sex as assignment adjustment factors. EB or TR was used for fixation of the soft graft on the femoral side. The primary endpoint was to compare the elongation distance of the suspensory device. MRIs were taken within seven days after ACLR and 3,6,12 months postoperatively and measured by a radiologist in a blinded fashion. Secondary endpoints included the side-to-side difference in anterior translation, one leg hop test (HOP index), Lachman test, lateral pivot shift test, and Lysholm score one year postoperatively. Results Twenty-eight patients (EB, n = 13; TR, n = 15) were followed for one year. There was no significant difference between EB and TR groups in elongation from the immediate postoperative period to 3, 6, 12 months after surgery. However, the non-inferiority of TR to EB (non-inferiority margin: 1.5 mm) was not proved by the difference in measured elongation between the two groups (TR – EB, lower 95% CI. AM: 1.80 mm; PL: 1.86 mm) at 6 months. There was no significant difference in anterior translation, HOP index, Lachman test, lateral pivot shift test, or Lysholm score. Conclusion EB and TR had similar graft retaining ability in vivo for 12 months, but the non-inferiority of TR against EB was not verified statistically.

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Section: Discussionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Randomized comparative study of suspension femoral fixation device in graft position maintenance in anterior cruciate ligament reconstruction: EndoButton CL vs TightRope RT

Sato

Mukai

et al. 2021

Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilit

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“…There have been only seven publications that studies about ACL reconstruction clinical outcomes using adjustable loop devices. These studies consistently show that adjustable loop devices and other femoral fixation methods bear similar functional outcomes, as evaluated by the International Knee Documentation Committee (IKDC) score, Tegner-Lysholm score, and other criteria [16], [17], [18], [19], [20], [21]. Loop loosening did not significantly differ, neither in radiographs nor clinically [18], [19, [20].…”

Section: Introductionmentioning

confidence: 73%

“…The longer follow-up period could be explained by stronger integration of the grafts in the femoral tunnel. Ranjan et al stated that the IKDC score was higher in 2 years rather than 6 months of follow-up [21]. There was no function deterioration of the ankle joint when compared to the normal ankle [28].…”

Section: Discussionmentioning

confidence: 98%

“…Ranjan et al compared 2 types of suspensory fixations, the adjustable loop (TightRope RT, Arthrex) and fixed loop (Endobutton CL Ultra, Smith and Nephew) in 102 patients [21]. The study concluded that the functional outcomes of both suspensory fixations using IKDC and Tegner-Lysholm scores showed no significant different in 2-years follow-up.…”

Section: Discussionmentioning

confidence: 99%

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Functional Outcomes and Hop Tests Results in Anterior Cruciate Ligament Reconstruction Patients with Adjustable Loop Fixation: 2-Years Follow-up

Рhatomy

Wahjudi²,

Prasetyo³

et al. 2020

Open Access Maced J Med Sci

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BACKGROUND: Grafts are ultimately integrated into the bone tunnels by either screws, cross-pins, or cortical suspension devices in anterior cruciate ligament (ACL) reconstruction. Investigation the usage of adjustable loop button is inadequate. AIM: The aim of this study was to identify knee functional outcome and serial hop test in ACL reconstruction with adjustable loop button in 2-years follow-up. METHODS: Chronic isolated ACL ruptured patients were reconstructed with adjustable loop button using peroneus longus autograft. We recorded knee functional outcome score using Tegner-Lysholm score, Modified Cincinnati score, and International Knee Documentation Committee (IKDC) at pre-operative and 2-years follow-up. Serial hop test was assessed at 6 months after surgery. RESULTS: Forty-seven patients fulfilled inclusion criteria with median age 22.0. Evaluation of functional outcome of Tegner-Lysholm score, Modified Cincinnati score, and IKDC showed significant improvement at 2-years follow-up compared to pre-operative. Serial hop test showed excellent result at 6 months after surgery. CONCLUSION: The result of knee functional score (Tegner-Lysholm score, Modified Cincinnati score, and IKDC) and serial hop test in ACL reconstruction with adjustable loop using peroneus longus autograft was excellent at 2-years follow-up. LEVEL OF EVIDENCE: Level 2, Retrospective Cohort Study.

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Laterally shifted tibial tunnel can be the risk of residual knee laxity for double-bundle anterior cruciate ligament reconstruction

Chiba

Yamamoto

Kimura

et al. 2021

Knee Surg Sports Traumatol Arthrosc

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Purpose To elucidate the relationship between graft tunnel position and knee laxity in the cases of double-bundle ACL reconstruction. Methods Total of 132 cases were included. Femoral and tibial tunnels were evaluated by quadrant method on 3D-CT. As additional reference of tibia, the distances from medial tibial spine to the tunnel center (D MS ) and from Parsons' knob to the tunnel center (D PK ) were evaluated; %D MS /ML and %D PK /AP were calculated (ML and AP: mediolateral and anteroposterior width of tibial plateau). Preoperative and postoperative (1 year from surgery) stabilities were evaluated by Lachman and pivot-shift procedures. If there was ≥ 2 mm side-to-side diference, the subject was deined as having anterior knee laxity (AKL); if the pivot-shift phenomenon was observed with IKDC grade ≥ 1, there was rotatory knee laxity (RKL). Multiple logistic regression analysis was conducted with the prevalence of AKL or RKL as the dependent variable and with tunnel positions as the independent variables. Results Overall, 21 subjects (15.9%) showed AKL, and 15 subjects (11.4%) showed RKL. Those with postoperative laxity showed higher %D MS /ML and higher femoral position than those without laxity. Regarding posterolateral bundle, logistic regression model estimated that %D MS /ML was associated with the prevalence of AKL (B = 0.608; p < 0.001) and RKL (B = 0.789; p < 0.001); %high-low femoral tunnel position (B = − 0.127; p = 0.023) was associated with that of RKL. Conclusion There was the risk of residual knee laxity in ACL-reconstructed knee when tibial tunnel shifted more laterally or higher femoral tunnel was created with regard to posterolateral bundle. Level of evidence III.

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In vivo comparison of a fixed loop (EndoButton CL) with an adjustable loop (TightRope RT) device for femoral fixation of the graft in ACL reconstruction: A prospective randomized study and a literature review

Cited by 16 publications

References 17 publications

Randomized comparative study of suspension femoral fixation device in graft position maintenance in anterior cruciate ligament reconstruction: EndoButton CL vs TightRope RT

Randomized comparative study of suspension femoral fixation device in graft position maintenance in anterior cruciate ligament reconstruction: EndoButton CL vs TightRope RT

Functional Outcomes and Hop Tests Results in Anterior Cruciate Ligament Reconstruction Patients with Adjustable Loop Fixation: 2-Years Follow-up

Laterally shifted tibial tunnel can be the risk of residual knee laxity for double-bundle anterior cruciate ligament reconstruction

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