Effects of Interference Fit Screw Length on Tibial Tunnel Fixation for Anterior Cruciate Ligament Reconstruction

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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Single-tunnel anatomic double-bundle anterior cruciate ligament reconstruction has the same effectiveness as double femoral, double tibial tunnel

Medicine ◽

10.1097/md.0000000000014851 ◽

2019 ◽

Vol 98 (11) ◽

pp. e14851

Author(s):

Xianxiang Xiang ◽

Zhenan Qu ◽

Honglin Sun ◽

Xiaojun Ma ◽

Weiming Wang ◽

...

Keyword(s):

Anterior Cruciate Ligament ◽

Anterior Cruciate Ligament Reconstruction ◽

Ligament Reconstruction ◽

Cruciate Ligament ◽

Tibial Tunnel ◽

Double Bundle ◽

Cruciate Ligament Reconstruction ◽

Anterior Cruciate

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Comparison of Three Techniques of Anterior Cruciate Ligament Reconstruction with Bone-Patellar Tendon-Bone Graft: Differences in Anterior Tibial Translation and Tunnel Enlargement with Each Technique

The American Journal of Sports Medicine ◽

10.1177/03635465030310022101 ◽

2003 ◽

Vol 31 (2) ◽

pp. 282-288 ◽

Cited By ~ 33

Author(s):

Hironori Otsuka ◽

Yasuyuki Ishibashi ◽

Eiichi Tsuda ◽

Kazuhiro Sasaki ◽

Satoshi Toh

Keyword(s):

Anterior Cruciate Ligament ◽

Anterior Cruciate Ligament Reconstruction ◽

Ligament Reconstruction ◽

Cruciate Ligament ◽

Tibial Tunnel ◽

Tunnel Enlargement ◽

Cruciate Ligament Reconstruction ◽

Fixation Group ◽

Anterior Cruciate ◽

Bone Patellar Tendon

Background: Anatomic fixation of the graft in anterior cruciate ligament reconstruction has improved stability of the reconstructed knee joint in experimental studies. Hypothesis: Anatomic fixation of the bone-patellar tendon-bone autograft will reduce tunnel enlargement and improve clinical results. Study Design: Prospective cohort study. Methods: Sixty patients were randomly divided into three groups: a nonanatomic fixation group (traditional single-incision reconstruction), an anatomic fixation group (reconstruction in which a bone plug was grafted into the tibial tunnel), and an anatomic fixation group with all-inside reconstruction. Stability of the knee joint was examined with a KT-1000 arthrometer at 2, 4, 6, 12, and 24 months after surgery. At 12 months, anteroposterior and lateral radiographs were made to assess tunnel enlargement. Results: Although the magnitude of tibial displacement gradually increased after reconstruction in all three groups, the anatomic fixation group had significantly better stability than the groups undergoing nonanatomic fixation or all-inside anatomic fixation at 4 and 6 months after anterior cruciate ligament reconstruction. However, there was no significant difference between the three groups at 24 months. Regarding the tibial tunnel, residual rates and enlargement of tunnels were different between the reconstruction techniques. The nonanatomic reconstruction group had significantly greater tunnel enlargement. Conclusion: Anatomic fixation of the graft decreased the tunnel enlargement but had no effect on knee stability at 2-year follow-up.

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