scholarly journals Anterior cruciate ligament reconstruction is associated with greater tibial tunnel widening when using a bioabsorbable screw compared to an all-inside technique with suspensory fixation

2018 ◽  
Vol 27 (8) ◽  
pp. 2577-2584 ◽  
Author(s):  
Edoardo Monaco ◽  
Mattia Fabbri ◽  
Andrea Redler ◽  
Edoardo Gaj ◽  
Angelo De Carli ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Tibial Tunnel ◽  
Tunnel Widening ◽  
Cruciate Ligament Reconstruction ◽  
Bioabsorbable Screw ◽  
Suspensory Fixation ◽  
Anterior Cruciate

Tibial Tunnel Widening after Hamstring Tendon Anterior Cruciate Ligament Reconstruction

2007 ◽  
Vol 35 (10) ◽  
pp. 1725-1730 ◽  
Author(s):  
W. Randall Schultz ◽  
Russell C. McKissick ◽  
Jesse C. DeLee
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Tibial Tunnel ◽  
Autogenous Bone ◽  
Tunnel Widening ◽  
Interference Screws ◽  
Cruciate Ligament Reconstruction ◽  
Anterior Cruciate

Background Tibial tunnel widening is a common phenomenon seen with hamstring anterior cruciate ligament reconstruction. Concern exists that increased tunnel widening can lead to delayed graft incorporation, graft laxity, or difficulties in revision surgery. Hypothesis Supplemental aperture fixation with autogenous bone cores or bioabsorbable interference screws will decrease tibial tunnel widening in hamstring anterior cruciate ligament reconstruction. Study Design Cohort study; Level of evidence, 3. Methods One hundred twenty-nine patients were divided into 3 groups based on type of aperture fixation: none, bioabsorbable interference screws, and autogenous bone cores. Tibial tunnel diameters were measured on plain radiographs at a minimum of 3 months postoperatively based on the timeline of tibial tunnel widening suggested by Simonian et al, and tunnel widening was quantified by the increase in tunnel diameters relative to initial reamer size. Results Means for tunnel widening based on both anteroposterior and lateral maximum tunnel width measures were significantly different between the 3 groups (P < .05, 1-way analysis of variances); however, compared with the means for the group receiving no aperture supplementation, the means for the group receiving bioabsorbable interference screws were more than 0.8 mm wider, representing a significant increase (P < .05, Bonferroni-adjusted t tests), while the means for the group receiving autogenous bone cores were less than 0.6 mm wider than the group without aperture supplementation and not significantly different (P > .25, Bonferroni-adjusted t tests). Conclusion Tibial tunnel aperture supplementation does not appear to decrease tunnel widening in hamstring anterior cruciate ligament reconstruction and may actually increase the amount of tibial tunnel widening.

scholarly journals Extra-articular migration of PEEK interference screw after anterior cruciate ligament reconstruction: a report of two cases

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Chao-Hua Fang ◽  
Ming Li ◽  
Yun-Feng Zhang ◽  
Hua Liu
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Tibial Tunnel ◽  
Interference Screw ◽  
Negative Effects ◽  
Cruciate Ligament Reconstruction ◽  
Screw Extrusion ◽  
Anterior Cruciate

Abstract Background The interference screw is the most popular device that fixes the graft for anterior cruciate ligament reconstruction, reducing the incidence of windshield effect and bungee effect. For the screw, either metallic, “bioresorbable,” or polyetheretherketone (PEEK) material is available. PEEK is popular and extensively used due to its stability, biocompatibility, radiolucency, and elastic modulus. Rare relevant complications were reported, but here, we report two cases of extra-articular migrations of PEEK interference screw from the tibial tunnel after anterior cruciate reconstruction. Case report An 18-year-old boy and a 56-year-old woman underwent anterior cruciate ligament reconstruction using a PEEK interference screw to fix the graft in the tibial tunnel. They suffered from screw extrusion from the tibial tunnel after 40 days and six months, respectively, with an incision rupture or palpable subcutaneous mass. They underwent a second operation and recovered well. Conclusions The exact incidence of extra-articular migrations of PEEK interference screws is unknown, but it seems to be quite low; despite this and its uncertain cause, the negative effects caused by the PEEK material need to be considered.

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