TightRope Versus Biocomposite Interference Screw for Fixation in Allograft ACL Reconstruction

Yari, Shahram S; Naga, Ashraf El; Patel, Amar; Qadeer, Ali A.; Shah, Anup

doi:10.2106/jbjs.oa.19.00057

Cited by 9 publications

(8 citation statements)

References 33 publications

(23 reference statements)

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“…The degree of flexion 6 months after surgery was 132° and 136° for the IF- and PFH-group, respectively. This confirms the findings of Yari et al [ 47 ] The PFH-group showed significantly ( p = 0.00529) better results at more than 100 days post-surgery, providing patients with increased mobility. This might be attributed to faster healing in the PFH-group, as a result of a primarily biological reconstruction of the ACL without metal or resorbable screws.…”

Section: Discussionsupporting

confidence: 91%

Re-rupture rate and the post-surgical meniscal injury after anterior cruciate ligament reconstruction with the Press-Fit-Hybrid®-technique in comparison to the interference screw technique: a retrospective analysis of 200 patients with at least 3 years follow-up

Volz¹,

Borchert

2022

Arch Orthop Trauma Surg

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Background There is currently no consensus regarding the preferred surgical procedure for the reconstruction of anterior cruciate ligament (ACL). The interference screw technique is widely used, but has been associated with a risk of graft damage. The Press-Fit-Hybrid®-technique is one of the alternatives for biological ACL-reconstruction with minimal implant requirements. The hypothesis of this retrospective analysis is, that the Press-Fit-Hybrid®-technique leads to better results with respect to re-rupture rate and secondary meniscal lesion than the interference-screw-technique. Methods To compare the re-rupture rate of the interference-screw-technique (IF) used until 2015 with the currently used Press-Fit-Hybrid®-technique (PFH), the last 100 patients of the IF-group and the first 100 patients of the PFH-group were retrospectively analyzed. Primary outcomes were re-rupture rate, complications and secondary meniscal injury. Additionally, laxity, Lachman and Pivot-shift and range of motion were evaluated. Results A mean follow-up of 4.2 and 5.3 years revealed 4% and 9% re-rupture rates and 1% and 2% complication rates in the PFH- and IF-group, respectively. In the PFH-group there were no re-ruptures in patients older than 23 years. Secondary meniscal injury post-surgery was 6% and 9% for the PFH and IF-group, respectively. Knee stability was similar in both groups. Range of motion was significantly better in the PFH-group, with 136° of flexion, 6 months after surgery. Conclusion For ACL-reconstruction the Press-Fit-Hybrid®-technique is an alternative new method. Low level of secondary meniscal lesions after surgery and high stability, is known to prevent later arthrosis of the knee. The encouraging observed trend of the reduction of the re-rupture rate in revision surgery and in young patients using the Press-Fit-Hybrid®-technique in comparison to the interference-screw-technique must be confirmed with further studies. Level of evidence Therapeutic Level III, retrospective cohort study.

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Section: Discussionsupporting

confidence: 91%

Re-rupture rate and the post-surgical meniscal injury after anterior cruciate ligament reconstruction with the Press-Fit-Hybrid®-technique in comparison to the interference screw technique: a retrospective analysis of 200 patients with at least 3 years follow-up

Volz¹,

Borchert

2022

Arch Orthop Trauma Surg

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“…Detailed search process is illustrated in Fig 1 . These included trials were published between 2002 and 2020, with 9 trials of CB vs CP [ 14 , 29 , 36 , 37 , 42 , 43 , 46 , 48 , 51 ], 9 of CB vs IS [ 18 , 30 – 33 , 35 , 44 , 45 , 50 ], and 8 of CP vs IS [ 16 , 34 , 38 – 41 , 47 , 49 ]. Follow-up time ranged from 6 months to 60 months.…”

Section: Resultsmentioning

confidence: 99%

Femoral fixation methods for hamstring graft in anterior cruciate ligament reconstruction: A network meta-analysis of controlled clinical trials

2022

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Objective To compare the clinical effectiveness of cortical button (CB), cross-pin (CP) and compression with interference screws (IS) fixation techniques in anterior cruciate ligament (ACL) reconstruction using hamstring graft. Methods Studies were systematically retrieved from PubMed, Embase, Cochrane Library and Web of Science up to May 20, 2021. Primary outcomes were KT-1000 assessment, International Knee Documentation Committee (IKDC) score A or B, Lachman’s test, pivot-shift test, visual analogue scale (VAS) score, Lysholm score, Tegner score, and Cincinnati Knee Score. Secondary outcomes included reconstruction failures and synovitis. League tables, rank probabilities and forest plots were drawn for efficacy comparison. Results Twenty-six controlled clinical trials (CCTs) with 1,824 patients undergoing ACL reconstruction with hamstring graft were included. No significant differences were found among CB, CP and IS fixation methods regarding the 10 outcomes. For KT-1000 assessment, IKDC score A or B, Lachman’s test, VAS score and pivot-shift test, CP had the greatest probability of becoming the best method, and IS may be the suboptimal method in 4 out of these 5 outcomes except pivot-shift test. Conclusions CP, CB and IS fixations have comparable clinical performance, while CP fixation is most likely to be the optimum fixation technique for hamstring graft in ACL reconstruction. Future larger-sample studies of high quality comparing these techniques in more clinical outcomes are required.

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“…The TightRope ® system is a kind of suture tape that is commonly used in treating acromioclavicular joint dislocation 39,40 and in other kinds of fixation. [41][42][43][44][45][46] It is a minimally invasive fixation method with sufficient stability. The technique of fixation with the TightRope ® system is simpler than that with IS screws and has no risk of nerve root injury.…”

Section: Discussionmentioning

confidence: 99%

“…Our technique utilized TightRope® system fixation, which is a new way to stabilize the posterior pelvic ring. The TightRope® system is a kind of suture tape that is commonly used in treating acromioclavicular joint dislocation 39,40 and in other kinds of fixation 41–46 . It is a minimally invasive fixation method with sufficient stability.…”

Section: Discussionmentioning

confidence: 99%

Minimally Invasive Percutaneous TightRope® System Fixation for an Unstable Posterior Pelvic Ring: Clinical Follow‐up and Biomechanical Studies

Zhang

Sui

et al. 2022

Orthopaedic Surgery

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Objective To evaluate the mechanical stability and clinical efficacy of minimally invasive percutaneous TightRope® systems applied via gun‐shaped reduction forceps for unstable posterior pelvic ring fractures. Materials and methods This study consists of two parts: a clinical retrospective study and a randomized controlled biomechanical test. For the clinical study, a retrospective analysis of posterior pelvic ring fractures was performed between June 2015 and May 2020. Eighteen patients underwent surgery using two TightRope® systems to fix a broken posterior pelvic ring because of unstable AO type C1 and C2 pelvic ring fractures. The patients were followed up for at least 2 years, and all patients were evaluated using the Majeed scoring system and vertical displacement. In the biomechanical tests, six embalmed adult pelvic specimens were used. The fractures were subjected to TightRope®, IS screw, and TBP fixation in a randomized block design. The specimens were placed in a biomechanical testing machine in a standing neutral posture. A cyclic vertical load of up to 500 N was applied, and the displacement of the specimens was recorded by the testing machine. The ultimate load in each group of specimens was recorded. The displacement and ultimate load were compared and analyzed by statistical methods. Results At a mean follow‐up of 38.89 ± 8.72 months, the functional Majeed score was excellent in 14 patients and good in four patients. The final radiological examinations showed that the outcome was excellent in 14 patients and good in four patients. In these patients, no serious clinical complications were found. Weight‐bearing was delayed in four patients. In biomechanical tests, the displacement of the specimens fixed with TightRope® was significantly lower than that of the specimens fixed with TBP (P < 0.05) when the load ranged from 300 to 500 N. The displacement in the IS screw group was significantly lower than that in either the TBP or TightRope® group (P < 0.05) when the load ranged from 0 to 500 N. The ultimate load in the IS screw group (1798 ± 83.53 N) was significantly greater than that in the TBP group (1352 ± 74.41 N) (t = 9.78, P < 0.0001) and the TightRope® group (1347 ± 54.28 N) (t = 11.11, P < 0.0001). However, no significant difference was observed between the TightRope® and TBP groups (t = 0.13, P = 0.90). Conclusion Percutaneous posterior TightRope® system shows strong stability in mechanical experiments and shows good results in clinical follow‐up while this system has certain advantages in lower surgical requirements and lower risk of related nerve and vascular structural damage.

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TightRope Versus Biocomposite Interference Screw for Fixation in Allograft ACL Reconstruction

Cited by 9 publications

References 33 publications

Re-rupture rate and the post-surgical meniscal injury after anterior cruciate ligament reconstruction with the Press-Fit-Hybrid®-technique in comparison to the interference screw technique: a retrospective analysis of 200 patients with at least 3 years follow-up

Re-rupture rate and the post-surgical meniscal injury after anterior cruciate ligament reconstruction with the Press-Fit-Hybrid®-technique in comparison to the interference screw technique: a retrospective analysis of 200 patients with at least 3 years follow-up

Femoral fixation methods for hamstring graft in anterior cruciate ligament reconstruction: A network meta-analysis of controlled clinical trials

Minimally Invasive Percutaneous TightRope® System Fixation for an Unstable Posterior Pelvic Ring: Clinical Follow‐up and Biomechanical Studies

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