Intraoperative complications using the Bio-Transfix femoral fixation implant in anterior cruciate ligament reconstruction

Abstract

The use of biodegradable Transfix femoral fixation technique is a safe and well-accepted method when performing anterior cruciate ligament reconstruction. We report on three cases of deformation and back out of the Bio-Transfix implant over the lateral, distal femoral cortex, with failure of the passing wire when advancing the graft into the femoral tunnel in one of these patients. Two of the patients presented with symptoms of iliotibial band friction syndrome, while the third patient was asymptomatic. The graft had clinically integrated demonstrating AP and rotational stability. The symptoms relieved after removal of the failed Bio-Transfix implants in the symptomatic patients. The aetiology of the implant failure and the alternative methods to avoid such complications are discussed.

A Comparison of Clinical Outcomes of Two Methods of Femoral Hamstring Graft Pin Fixation in Anterior Cruciate Ligament Reconstruction

“…The Transfix can cause iliotibial band friction syndrome due to prominent lateral hardware though this was not found in our series of patients [10][11][12] . The Rigidfix pins can theoretically spear the graft which has been hypothesised to result in increased graft slippage compared to Transfix due to splitting of the collagen fibres of the graft 3 .…”

“…This difference could explain the difference in anterior translation between the two groups in our study. Both devices require their own respective insertion techniques and apart from missing the femoral tunnel altogether during graft placement which can occur with both devices, other devicespecific complications have occurred with the Transfix device during insertion such as broken or twisted graft-passing wires [12][13][14] . Supracondylar femur fractures have been described with the use of Transfix too though this was not encountered in our study 15,16 .…”

Revision of anterior cruciate ligament reconstruction with patellar tendon allograft and autograft: 2- and 5-year results

“…The pull-out forces, however, show a high standard deviation, because the screw does not always lie parallel to the bone block [32]. The transverse locking with so-called "cross pins" can fail by implant breakage [8] or by missing the graft [28].…”

Delayed Knee Locking after Complicated Anterior Cruciate Ligament Reconstruction Despite Good Stability Using A Bio-Transfix

“…The implants extruded laterally and the implant-tail was broken in both cases. Kokkinakis et al5) also reported a case of wire breakage that also showed good stability. As reported by Lee et al7), there is some possibility of a delayed foreign body reaction to the Bio-Transfix implant.…”