Two-year Outcome With the AperFix System for ACL Reconstruction

Uribe, John W.; Arango, Dillon; Frank, Jeremy S.; Kiebzak, Gary M.

doi:10.3928/01477447-20130122-17

Cited by 13 publications

(10 citation statements)

References 16 publications

(26 reference statements)

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“…Four studies reported a significant positive correlation between patient reported outcome measures (eg, Tegner score, Lysholm score, and International Knee Documentation Committee [IKDC] score) and patient satisfaction. 20 , 31 , 34 , 36 Two studies reported a significant correlation between objective functional measurements and patient satisfaction. 20 , 21 One study found that a higher grade postoperative pivot shift was associated with lower patient satisfaction after ACL reconstruction.…”

Section: Resultsmentioning

confidence: 99%

How Are We Measuring Patient Satisfaction After Anterior Cruciate Ligament Reconstruction?

Kahlenberg

Nwachukwu

Ferraro

et al. 2016

Orthopaedic Journal of Sports Medicine

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Background:Reconstruction of the anterior cruciate ligament (ACL) is one of the most common orthopaedic operations in the United States. The long-term impact of ACL reconstruction is controversial, however, as longer term data have failed to demonstrate that ACL reconstruction helps alter the natural history of early onset osteoarthritis that occurs after ACL injury. There is significant interest in evaluating the value of ACL reconstruction surgeries.Purpose:To examine the quality of patient satisfaction reporting after ACL reconstruction surgery.Study Design:Systematic review; Level of evidence, 4.Methods:A systematic review of the MEDLINE database was performed using the PubMed interface. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines as well as the PRISMA checklist were employed. The initial search yielded 267 studies. The inclusion criteria were: English language, US patient population, clinical outcome study of ACL reconstruction surgery, and reporting of patient satisfaction included in the study. Study quality was assessed using the Newcastle-Ottawa scale.Results:A total of 22 studies met the inclusion criteria. These studies comprised a total of 1984 patients with a mean age of 31.9 years at the time of surgery and a mean follow-up period of 59.3 months. The majority of studies were evidence level 4 (n = 18; 81.8%), had a mean Newcastle-Ottawa scale score of 5.5, and were published before 2006 (n = 17; 77.3%); 5 studies (22.7%) failed to clearly describe their method for determining patient satisfaction. The most commonly used method for assessing satisfaction was a 0 to 10 satisfaction scale (n = 11; 50.0%). Among studies using a 0 to 10 scale, mean satisfaction ranged from 7.4 to 10.0. Patient-reported outcome and objective functional measures for ACL stability and knee function were positively correlated with patient satisfaction. Degenerative knee change was negatively correlated with satisfaction.Conclusion:The level of evidence for studies reporting patient satisfaction is low, and the methodologies for reporting patient satisfaction are variable. Additionally, within the past decade there has been a significant decline in the inclusion of this outcome measure within published ACL studies. As sports surgeons are increasingly called on to demonstrate the value of operative procedures, attention should be paid to understanding and reporting patient satisfaction.

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Section: Resultsmentioning

confidence: 99%

How Are We Measuring Patient Satisfaction After Anterior Cruciate Ligament Reconstruction?

Kahlenberg

Nwachukwu

Ferraro

et al. 2016

Orthopaedic Journal of Sports Medicine

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“…Previous studies with the AperFix System have reported good to excellent outcomes after ACL reconstruction. 16,33 The majority of these studies were conducted in patients undergoing a transtibial nonanatomical technique. Only a single study by Mulcahey et al 32 compared anatomical and nonanatomical placement of the femoral tunnel with this reconstruction system.…”

Section: Discussionmentioning

confidence: 99%

“…15 This system is believed to improve bonetendon healing by compressing tendon over bone, increasing the resistance to pullout and decreasing the laxity of the graft in its tunnel. 16 There is a substantial body of research reporting the influence of the position of the femoral tunnel on joint laxity, but most of the studies were conducted in patients undergoing secondary fixation methods. The current authors believe femoral tunnel widening may be important in direct graft fixation methods and may play a greater role in determining clinical outcomes than the current literature suggests.…”

Section: Comparison Of Anteromedial and Transtibial Acl Reconstructiomentioning

confidence: 99%

Comparison of Anteromedial and Transtibial ACL Reconstruction Using Expandable Fixation

Özel¹,

Yücel²,

Orman³

et al. 2017

Orthopedics

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The influence of anatomical or nonanatomical femoral tunnel position on tunnel widening and clinical outcomes in patients undergoing anterior cruciate ligament (ACL) reconstruction is not fully understood. This retrospective study examined the influence of tunnel width and placement on anterior knee stability and clinical outcomes after ACL reconstruction using the AperFix System (Cayenne Medical Inc, Scottsdale, Arizona), a direct expandable fixation technique with autologous hamstring grafts. The records of 80 patients (79 men and 1 woman) who underwent ACL reconstruction were evaluated. In 38 patients, anatomical femoral tunnel placement was performed via an accessory medial portal (anteromedial group); in the remaining 42 patients, the femoral tunnel was positioned nonanatomically using a transtibial technique (transtibial group). Mean follow-up was 40.7 months (range, 27-60 months). Postoperative knee kinetics were measured, and clinical outcomes were assessed using International Knee Documentation Committee, Lysholm, and Tegner scores. Femoral tunnel widening was measured by comparing postoperative radiographs with final follow-up radiographs. Femoral tunnel width was significantly greater (P<.001) and anterior knee translation was significantly higher (P=.01) in the transtibial group. Lysholm and Tegner scores were not significantly different (P>.05) between the 2 groups. These findings suggest that femoral tunnel widening is associated with increased anterior joint laxity when a direct fixation technique is used for ACL reconstruction, particularly in nonanatomically positioned femoral tunnels. Anatomical femoral tunnel placement provides better anterior stability and less tunnel widening than transtibial tunnel placement; however, these benefits did not produce a detectable advantage in clinical outcomes measures. [Orthopedics. 2017; 40(3):e532-e537.].

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“…They concluded that the AperFix system provides durable fixation for ACL reconstruction with a low complication rate and good clinical results. 22 …”

Section: Discussionmentioning

confidence: 99%

Outcome of transtibial AperFix system in anterior cruciate ligament injuries

Görmeli

Karakaplan

et al. 2015

IJOO

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Background:The anterior cruciate ligament (ACL) is one of the major stabilizing factor of the knee that resist anterior translation, valgus and varus forces. ACL is the most commonly ruptured ligament of the knee. The graft fixation to bone is considered to be the weakest link of the reconstruction. According to the parallel forces to the tibial drill hole and the quality of tibial metaphyseal bone is inferior to femoral bone stock, graft fixation to the tibia is more difficult to secure. AperFix system (Cayenne Medical, Inc., Scottsdale, Arizona, USA) which consists femoral and tibial component that includes bioinert polymer polyetheretherketone (PEEK) is one of the new choice for ACL reconstruction surgery. aim of this study was to assess the clinical outcomes and fixation durability of the AperFix (Cayenne Madical, Inc., Scottsdale, Arizona, USA) system and to determine the effect of patient's age in arthroscopic reconstruction of the anterior cruciate ligament.Materials and Methods:Patients with symptomatic anterior cruciate ligament rupture underwent arthroscopic reconstruction. Patients were evaluated in terms of range of motion (ROM) values; Lysholm, Cincinati and Tegner activity scales; laxity testing and complications. Femoral tunnel widening was assessed by computer tomography scans. Early postoperative and last followup radiographs were compared.Results:Fifty one patients were evaluated with mean followup of 29 months (range 25–34 months). Mean age at the surgery was 26.5 ± 7.2 years. Lysholm, Cincinati and Tegner activity scales were significantly higher from preoperative scores (Lysholm scores: Preoperative: 51.4 ± 17.2, postoperative: 88.6 ± 7.7 [P < 0.001]; Tegner activity scores: Preoperative 3.3 ± 1.38, postoperative: 5.3 ± 1.6 [P < 0.001]; Cincinati scores: Preoperative: 44.3 ± 17, postoperative: 81.3 ± 13.9 [P < 0.001]). The mean femoral tunnel diameter increased significantly from 9.94 ± 0.79 mm postoperatively to 10.79 ± 0.95 mm (P < 0.05). The mean ROM deficit (involved vs. contra knee) was −7.2 ± 16 (P < 0.001). There was no significant difference for knee score, ROM deficits (<30 years: −7.3 ± 15 and >30 years −7.06 ± 19) and femoral tunnel enlargement (<30 years: 0.83 ± 0.52 and >30 years 0.87 ± 0.43) of the patients with below and above 30 year. There was no significant difference for knee scores and femoral tunnel enlargement between patients with meniscal injuries and don’t have meniscus lesions.Conclusion:The AperFix system gives satisfactory clinical and radiological results with low complication rate. However, long term clinical and radiological results are needed to decide the ideal anterior cruciate ligament reconstruction method.

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Two-year Outcome With the AperFix System for ACL Reconstruction

Cited by 13 publications

References 16 publications

How Are We Measuring Patient Satisfaction After Anterior Cruciate Ligament Reconstruction?

How Are We Measuring Patient Satisfaction After Anterior Cruciate Ligament Reconstruction?

Comparison of Anteromedial and Transtibial ACL Reconstruction Using Expandable Fixation

Outcome of transtibial AperFix system in anterior cruciate ligament injuries

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