Poly D, L lactide interference screws for anterior cruciate ligament reconstruction (SS-64)

Background Biodegradable cross-pins have been shown to provide higher failure loads than do screws for fixation of hamstring tendons under laboratory conditions. Purpose To compare the clinical results of biodegradable pins (RigidFix) and interference screws (BioCryl) for fixation of hamstring grafts in arthroscopically assisted anterior cruciate ligament reconstruction. Study Design Randomized controlled trial; Level of evidence, 1. Methods To test the hypothesis of a difference of 1.0 ± 1.2 mm in anterior knee laxity between the two fixation options, 54 patients were randomly assigned to groups via a block randomization scheme and sealed envelopes. All patients underwent standardized hamstring graft reconstruction and had similar postoperative aftercare by an accelerated rehabilitation protocol. Measures assessed at baseline and after 1 and 2 years of follow-up included (1) the side-to-side difference in anterior laxity (KT-1000 arthrometer), (2) Short Form 36 physical and mental component scores, and (3) the International Knee Documentation Committee form scores. Results After 1 and 2 years, 26 and 21 patients in the BioCryl group and 28 and 24 patients in the RigidFix group were available for follow-up examination. No significant difference was noted in instrumented anterior translation between BioCryl and RigidFix fixation: 1 year, 0.11 (95% CI, —0.60 to 0.82; P = .7537); 2 years, 0.33 (95% CI, —0.43 to 1.08 mm; P = .3849). Also, there were no significant differences in the mean physical and mental component scores and International Knee Documentation Committee form scores and in overall complication and surgical revision rates. A pin dislocation was classified as the sole procedure-specific serious adverse event. Conclusion Bioresorbable pins do not provide better clinical results than do resorbable interference screws for hamstring graft fixation in anterior cruciate ligament reconstruction surgery.

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Clinical Outcome Comparing Poly-L-lactic acid (PLLA) Bioabsorbable Interference Screws and Cortical Button-Post Fixation in Arthroscopic Anterior Cruciate Ligament Reconstruction

Revista de Chimie ◽

10.37358/rc.20.4.8078 ◽

2020 ◽

Vol 71 (4) ◽

pp. 384-389

Author(s):

Claudiu Daniel Chitea ◽

Alina Dia Trambitas Miron ◽

Gheorghe Tomoaia ◽

Cristian Trambitas

Keyword(s):

Anterior Cruciate Ligament ◽

Anterior Cruciate Ligament Reconstruction ◽

Ligament Reconstruction ◽

Cruciate Ligament ◽

Graft Fixation ◽

Fixation Method ◽

Hamstring Tendons ◽

Interference Screws ◽

Cruciate Ligament Reconstruction ◽

Anterior Cruciate

A good fixation for anterior cruciate ligament reconstruction with hamstring tendons graft is important to withstand the stress on the graft resulting from post-operative rehabilitation. The optimal hamstring tendons graft fixation method remains uncertain within the sports medicine literature. The most used fixation techniques include: suspensory fixation with cortical-buttons, transfemoral fixation with cross-pins, and tunnel aperture fixation with interference screws. Patient recruitment and baseline data collection of this study were done at our hospital between July 2011- March 2016. In this study we included the records of 80 patients with an ACL rupture who elected to undergo ACL reconstructive surgery with allograft tissue. In our study the patients were mixed in 2 groups: (A) patients with interference bone screw group used for anterior ligament reconstruction graft fixation in both the femur and tibia and (B) patients with the cortical flip button group underwent graft fixation with the button on the femoral side and an interference screw on the tibial side. Our clinical study shows no significant differences in the patients� outcomes after using these two fixation devices.

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