Reconstruction of the anterior cruciate ligament using bone-patellar tendon-bone graft with double biodegradable femoral pin fixation

Abstract

The purpose of this study was to evaluate the early clinical outcomes of the bone-patellar tendon-bone (BPTB) anterior cruciate ligament (ACL) reconstruction using biodegradable cross pin fixation. The nature of this study is a prospective nonrandomized clinical outcome study. Thirty-five patients who underwent BPTB ACL reconstruction with a minimum of 2 years follow-up evaluation were included in the study. Thirty BPTB autografts and five BPTB allografts were fixed with two biodegradable 2.7 mm cross pins (Rigid Fix) on the femoral side. Clinical evaluation included International Knee Documentation Committee (IKDC), Lysholm and Tegner activity score, and Telos stress device measurements. The average Lysholm knee score was 94.7 (of 100). Twenty-four patients reported an excellent result. The other eight patients were in a good group. According to the IKDC scores, 23 (66%) patients reported normal function, 12 (34%) patients reported nearly normal function, and no (0%) patient reported abnormal or severely abnormal function. Telos stress device values were less than 3 mm of sagittal displacement in 28 patients and 5 mm in 7 patients. No patients complained that their knees gave way fully, even with moderate or strenuous activities. All of the patients have returned to their preinjury level of activity and athletic participation. Clinical results support this technique as a reliable alternative for patellar tendon fixation in ACL reconstruction.

Anterior Cruciate Ligament Reconstruction by Using Bioabsorbable Femoral Cross Pins: MR Imaging Findings at Follow-up and Comparison with Clinical Findings

“…Therefore, the fi xation technique has to be strong enough to withstand pullout forces during this early postoperative period. Femoral graft fi xation by using bioabsorbable cross pins has been reported to be a reliable procedure for ACL reconstruction (5)(6)(7)(8)(9). Numerous bioabsorbable implants have been used for different fi xation procedures since…”

Clinical Comparison of Fixation Methods for Patellar Bone Quadriceps Tendon Autografts in Anterior Cruciate Ligament Reconstruction

“…A few authors pointed out that with the cross-pin technique, almost maximum bone-to-bone contact surface in the femoral tunnel is achieved. 17 Consequently, because of the 360° bone block exposure within the tunnel, regeneration in the bone tunnel with cross-pins can be expected to be better than with screw fixation. In various studies, no synovial reactions during the degradation process of the cross-pins have been described.…”

Graft choices and fixation types in anterior cruciate ligament reconstruction

“…In a prospective nonrandomized clinical study by Mahirogullari et al 20 the results of 35 patients who had ACL reconstruction using the rigid fix femoral fixation method were analyzed. At the 2-year follow-up, the average Lysholm score was 94.7 and 24 patients reported IKDC scores as excellent, and 12 reported nearly normal knee function while none reported abnormal function.…”