Bone ingrowth into open architecture PEEK interference screw after ACL reconstruction

Abstract Purpose Open or fenestrated interference screw design that allow bone ingrowth is a concept for improved bone healing to softtissue graft and bone filling in bone tunnels after anterior cruciate ligament reconstruction (ACLR) The aim of the current study was to assess CT scanning evaluated bone ingrowth into an open architecture interference screws in the tibial tunnel of patients undergoing ACL with soft tissue grafts. It was hypothesized that open architecture interference screws would stimulate bone ingrowth into the screw cavities. Methods Twelve patients requiring ACLR were included. They underwent arthroscopic ACLR with semitendinosus−/gracilis tendon graft and an open architecture polyetheretherketone (PEEK) interference screw. The patients were scanned with a multi-slice CT scanner two weeks, six and twelve months postoperatively. On CT reconstruction slices bone ingrowth into the screw was measured. Subjective and objective clinical outcome international knee documentation committee score and instrumented knee laxity determination were collected. Results At six months no implants demonstrated more than 10% bone ingrowth. At twelve months 42% (5/12) implants had more than 10% bone ingrowth (p = 0.009). The average bone filling into the screws was 7.7%. There was no tunnel widening or cyst formation seen in relation to any of the implants. Subjective IKDC score improved significantly from 50.6 baseline to 80.1 at 24 month follow-up. Preoperative side-to-side knee laxity improved from 3.7 (2.1) to 1.4 (1.2) mm at twelve months. There were no serious adverse events in relation to the new open architecture thread PEEK interference screw during or after hamstring ACL reconstruction. Conclusion The present study demonstrated that open architecture thread PEEK interference screw can stimulate bone ingrowth into the screws after soft tissue ACL reconstruction with at 12 months with an average bone filling into screws was 7.7%. Knee stability, functional, subjective and objective outcomes were similar to large volume ACL outcome studies. Trial registration The study was registered at ClinicalTrials # NCT02382341. 12-09-2014. Level of evidence IV.

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Bone ingrowth into open architecture PEEK interference screw after ACL reconstruction

10.21203/rs.3.rs-28524/v1 ◽

2020 ◽

Author(s):

Martin Lind ◽

Torsten Nielsen ◽

Ole Gade Sørensen ◽

Bjarne Mygind-Klavsen ◽

Peter Faunø ◽

...

Keyword(s):

Soft Tissue ◽

Acl Reconstruction ◽

Bone Ingrowth ◽

Knee Laxity ◽

Interference Screw ◽

Open Architecture ◽

Interference Screws ◽

Bone Tunnels ◽

Bone Filling ◽

Average Bone

Abstract Purpose Open or fenestrated interference screw design that allow bone ingrowth is a concept for improved bone healing to softtissue graft and bone filling in bone tunnels after anterior cruciate ligament reconstruction (ACLR) The aim of the current study was to assess CT scanning evaluated bone ingrowth into an open architecture interference screws in the tibial tunnel of patients undergoing ACL with soft tissue grafts. It was hypothesized that open architecture interference screws would stimulate bone ingrowth into the screw cavities. Methods Twelve patients requiring ACLR were included. They underwent arthroscopic ACLR with semitendinosus-/gracilis tendon graft and an open architecture polyetheretherketone (PEEK) interference screw. The patients were scanned with a multi-slice CT scanner two weeks, six and twelve months postoperatively. On CT reconstruction slices bone ingrowth into the screw was measured. Subjective and objective clinical outcome international knee documentation committee score and instrumented knee laxity determination were collected. Results At six months no implants demonstrated more than 10 % bone ingrowth. At twelve months 42 % (5/12) implants had more than 10 % bone ingrowth (p = 0.009). The average bone filling into the screws was 7.7 %. There was no tunnel widening or cyst formation seen in relation to any of the implants. Subjective IKDC score improved significantly from 50.6 baseline to 80.1 at 24 month follow-up. Preoperative side-to-side knee laxity improved from 3.7 (2.1) to 1.4 (1.2) mm at twelve months. There were no serious adverse events in relation to the new open architecture thread PEEK interference screw during or after hamstring ACL reconstruction. Conclusion The present study demonstrated that open architecture thread PEEK interference screw can stimulate bone ingrowth into the screws after soft tissue ACL reconstruction with at twelve months with an average bone filling into screws was 7.7 %. Knee stability, functional, subjective and objective outcomes were similar to large volume ACL outcome studies. Trial registration The study was registered at ClinicalTrials # NCT023882341.

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Stacked Biocomposite Screws in a Single-Stage Revision Anterior Cruciate Ligament Reconstruction Has Acceptable Fixation Strength in a Porcine Cadaveric Model

The American Journal of Sports Medicine ◽

10.1177/03635465211015192 ◽

2021 ◽

pp. 036354652110151

Author(s):

Hasan Baydoun ◽

Ian D. Engler ◽

Ali Hosseini ◽

Lance LeClere ◽

Joeri Zoon ◽

...

Keyword(s):

Bone Loss ◽

Acl Reconstruction ◽

Cruciate Ligament ◽

Interference Screw ◽

Single Stage ◽

Fixation Strength ◽

Revision Acl Reconstruction ◽

Group 2 ◽

Bone Tunnels ◽

Primary Acl Reconstruction

Background: Stacked screws is a commonly used technique in single-stage revision anterior cruciate ligament (ACL) reconstruction in the setting of bone loss, but there are limited data to support its use. Hypothesis: Two configurations of a biocomposite stacked screws construct have similar fixation strength and linear stiffness as a primary ACL reconstruction construct in a biomechanical model. Study Design: Controlled laboratory study. Methods: A total of 30 porcine legs were divided into 3 groups. Group 1 underwent primary ACL reconstruction with a patellar tendon graft fixed into the femur, with an 8-mm biocomposite interference screw of beta-tricalcium phosphate and poly lactide-co-glycolide. For a revision ACL reconstruction model, groups 2 and 3 had bone tunnels created and subsequently filled with 12-mm biocomposite screws. New bone tunnels were drilled through the filler screw and the surrounding bone, and the patellar bone plug was inserted. Group 2 was fixed with 8-mm biocomposite screws on the side of the graft opposite the filler screw, while group 3 had the interference screw interposed between the graft and the filler screw. The construct was loaded at 1.5 mm/s in line with the tunnel until failure. Load to failure, linear stiffness, and mode of failure were recorded. Results: The mean pullout strength for groups 1, 2, and 3 was 626 ± 145 N, 653 ± 152 N, and 720 ± 125 N, respectively ( P = .328). The mean linear stiffness of the construct in groups 1, 2, and 3 was 71.4 ± 9.9 N/mm, 84.1 ± 11.1 N/mm, and 82.0 ± 10.8 N/mm, respectively. Group 2 was significantly stiffer than group 1 ( P = .037). Conclusion: Two configurations of a biocomposite stacked screws construct for a single-stage revision ACL reconstruction in the setting of bone loss show a similar fixation strength and linear stiffness to a primary ACL reconstruction at time zero in a porcine model. Clinical Relevance: In the setting of bone loss from tunnel malpositioning, a single-stage revision ACL reconstruction using a stacked screws construct may provide adequate fixation strength and linear stiffness.

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Whether sutures reduce the graft laceration caused by interference screw in anterior cruciate ligament reconstruction? A biomechanical study in vitro

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04457-5 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Yuanjun Teng ◽

Xiaohui Zhang ◽

Lijun Da ◽

Jie Hu ◽

Hong Wang ◽

...

Keyword(s):

Acl Reconstruction ◽

Cruciate Ligament ◽

Interference Screw ◽

Biomechanical Study ◽

Interference Screws ◽

Suture Group ◽

Anterior Cruciate ◽

Biomechanical Tests ◽

Single Insertion

Abstract Background Interference screw is commonly used for graft fixation in anterior cruciate ligament (ACL) reconstruction. However, previous studies had reported that the insertion of interference screws significantly caused graft laceration. The purposes of this study were to (1) quantitatively evaluate the graft laceration from one single insertion of PEEK interference screws; and (2) determine whether different types of sutures reduced the graft laceration after one single insertion of interference screws in ACL reconstruction. Methods The in-vitro ACL reconstruction model was created using porcine tibias and bovine extensor digitorum tendons of bovine hind limbs. The ends of grafts were sutured using three different sutures, including the bioabsorbable, Ethibond and ultra-high molecular weight polyethylene (UHMWPE) sutures. Poly-ether-ether-ketone (PEEK) interference screws were used for tibial fixation. This study was divided into five groups (n = 10 in each group): the non-fixed group, the non-sutured group, the absorbable suture group, the Ethibond suture group and the UHMWPE suture group. Biomechanical tests were performed using the mode of pull-to-failure loading tests at 10 mm/min. Tensile stiffness (newtons per millimeter), energy absorbed to failure (in joules) and ultimate load (newtons) were recorded for analysis. Results All prepared tendons and bone specimens showed similar characteristics (length, weight, and pre-tension of the tendons, tibial bone mineral density) among all groups (P > 0.05). The biomechanical tests demonstrated that PEEK interference screws significantly caused the graft laceration (P < 0.05). However, all sutures (the bioabsorbable, Ethibond and UHMWPE sutures) did not reduce the graft laceration in ACL reconstruction (P > 0.05). Conclusions Our biomechanical study suggested that the ultimate failure load of grafts was reduced of approximately 25 % after one single insertion of a PEEK interference screw in ACL reconstruction. Suturing the ends of the grafts using different sutures (absorbable, Ethibond and UHMWPE sutures) did not decrease the graft laceration caused by interference screws.

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Whether Sutures Reduce the Graft Laceration Caused by Interference Screw in Anterior Cruciate Ligament Reconstruction a Biomechanical Study in Vitro

10.21203/rs.3.rs-143941/v1 ◽

2021 ◽

Author(s):

Yuanjun Teng ◽

Lijun Da ◽

Xiaohui Zhang ◽

Hong Wang ◽

Hua Han ◽

...

Keyword(s):

Anterior Cruciate Ligament ◽

Acl Reconstruction ◽

Cruciate Ligament ◽

Interference Screw ◽

Biomechanical Study ◽

Protective Effects ◽

Mineral Density ◽

Interference Screws ◽

Anterior Cruciate

Abstract Background: Interference screw is commonly used for graft fixation in anterior cruciate ligament (ACL) reconstruction However, previous studies h a d reported that the insertion of interference screws significantly caused graft laceration . The purpose of this study was to determine whether sutures reduce d the graft laceration from the insertion of interference screws in ACL reconstruction. Methods: Porcine tibias and bovine extensor tendons were used for establishing a knee model of ACL reconstruction in vitro . The ends of grafts were sutured using three different sutures, including the bioabsorbable, Ethibond and ultra high molecular weight polyethylene (UHMWPE) sutures Poly ether ether ketone (PEEK) interference screw s w ere used fortibial fixation Biomechanical tests were performed to investigate the protective effects of different sutures on grafts Results : All prepared tendons and bone specimens showed similar characteristics (length, weight, and pre tension of the tendons, tibial bone mineral density) among all groups ( P 0.05). The biomechanical test s demonstrated that PEEK interference screw s significantly caused the graft laceration P 0.05). However, all sutures (the bioabsorbable, Ethibond and UHMWPE sutures) did not reduce the graft laceration in ACL reconstruction P 0.05). Conclusions : PEEK interference screw s significantly weakened the biomechanical properties of grafts during tibial fixation in ACL reconstruction. Absorbable Ethibond and UHMWPE sutures did not provide protective effects on grafts during ACL reconstruction.

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Transfemoral Fixation in Soft Tissue Cruciate Ligament Reconstructions – Composite Versus Polymeric Implant Analysis

Key Engineering Materials ◽

10.4028/www.scientific.net/kem.587.397 ◽

2013 ◽

Vol 587 ◽

pp. 397-403

Author(s):

Dan Laptoiu ◽

Rodica Marinescu ◽

Iozefina Botezatu

Keyword(s):

Soft Tissue ◽

Bone Ingrowth ◽

Cruciate Ligament ◽

Ceramic Composites ◽

The Body ◽

Volume Loss ◽

Tunnel Enlargement ◽

Press Fit ◽

Bone Tunnels ◽

Transfemoral Fixation

Different methods are available for ﬁxation on the femoral side of a quadruple soft tissue autograft in anterior cruciate ligament reconstruction and the best method is still to be found. There are also a large number of polymers in current practice, with a trend towards ceramic composites, required for better bone formation around the implant. If ceramic – polymer composites have better bioactive properties can be demonstrated only by long term in vivo follow up. Several methods of trans-femoral fixation are currently in use in our clinic – two of them being compared in this study: Rigidfix (Mitek DePuy Westwood, MA) and Biosteon (Stryker). First system produces a very stiff fixation using two implant pins made of poly-L-lactic acid (PLLA); the second technique is using a large composite (25% hydroxyapatite and 75% PLLA) suspension system with the mechanical advantage of achieving a “ press-fit” graft fixation in the tunnel. We prospectively follow our cases with clinical visits at 1, 3, 6 and 12 months – for research purposes, in a series of 20 cases (10 from each group) MRI (Siemens, 1,5 Tesla) were performed at same time intervals. Volume loss of the implant, tunnel enlargement, presence of osteolysis, ﬂuid lines, edema and postoperative pin replacement by bone tissue were evaluated. There was no edema or signs of inﬂammation around the bone tunnels at more than 24 months of folllow-up. Several of the Biosteon sites were surrounded by an area of increased signal on the fat-suppressed images. At 12 months, the femoral implants showed an average volume loss of 80% (±10%) P\0.05), respectively. At 3, 6, and 12 months volume losses range from 5 % (±2%), 29% (±19%) and 89% (±7%) for the composite implant. The femoral tunnel enlargement was less than 50% of the original bone tunnel volume after 12 months. Bone ingrowth was observed in all patients. Use of a composite ceramic – polymer bioabsorbable material (enhanced to form bone) will be easily incorporated by the body, retain strength for an adequate period of time, obviate the need for secondary procedures such as hardware removal, and facilitate revision surgery.

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Clinical comparison between femoral transfixation and bioscrew fixation using hamstring tendon graft for ACL reconstruction

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20174664 ◽

2017 ◽

Vol 3 (6) ◽

pp. 1099

Author(s):

Anil Kumar Mishra ◽

Barun Datta ◽

Varunendra Bahadur Singh ◽

Biraj Gogoi ◽

S. K. Rai ◽

...

Keyword(s):

Acl Reconstruction ◽

Femoral Condyle ◽

Knee Laxity ◽

Hamstring Tendon ◽

Tendon Graft ◽

Interference Screw ◽

Fixation Technique ◽

Significant Difference ◽

Hamstrings Tendon ◽

Femoral Side

Background: One of the popular graft choices for ACL reconstruction have been Hamstrings tendon autograft. There is no consensus on the ideal technique of fixation of hamstrings graft to femoral condyle. Theoretically we hypothesized that transfixation method of hamstrings graft fixation to femoral condyle should be superior to bio-interference screw fixation technique. Hence aim of our study is to compare this two fixation methods of hamstrings autografts clinically.Methods: 50 clinically and radiologically proven ACL deficient fighting soldiers are selected for the study. In group A; 25 patients underwent ACL reconstruction with Bioscrew using aperture technique on femoral side. Other 25 patients in group B underwent ACL reconstruction with transfixation screw using cortico-cancellous fixation technique on femoral side. In both groups quadrupled semitendinosus autograft is utilized. All the patients evaluated for functional outcome at the end of 6 weeks and at 6 months and at the end of 1 year following the procedure. The subjects are evaluated using the modified Lysholm knee score and knee laxity is measured by Rolimeter.Results: At 01 year post op. there was no statistically significant difference in both groups in terms of Manual laity tests,Rollimeter laity measurement and Lysholm knee score.The overall satisfactory result (Excellent + Good) in both the groups at 01 year follow up were 98% by Lysholm score.Conclusions: Transfixation and Bioscrew fixation showed comparable results in manual knee laxity tests, instrumental knee laxity tests using Rolimeter, Lyslohm scores and high patient satisfaction, with almost 96% of patients in both groups returned to their pre-injury levels.

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Significant Loss of ACL Graft Force With Tibial-Sided Soft Tissue Interference Screw Fixation Over 24 Hours: A Biomechanical Study

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120916437 ◽

2020 ◽

Vol 8 (5) ◽

pp. 232596712091643

Author(s):

Philipp Kruppa ◽

Anne Flies ◽

Dag Wulsten ◽

Robert Collette ◽

Georg N. Duda ◽

...

Keyword(s):

Soft Tissue ◽

Acl Reconstruction ◽

Cruciate Ligament ◽

Interference Screw ◽

Fixation Strength ◽

Screw Length ◽

Screw Diameter ◽

Tissue Grafts ◽

Soft Tissue Grafts

Background: Tibial-sided graft fixation is thought to be critical for the success of anterior cruciate ligament (ACL) reconstruction. Nevertheless, little is known about the graft force after fixation during the first 24 hours after surgery or the influence of screw diameter and length during this time. Purpose: To investigate the force, over the course of 24 hours, in soft tissue grafts secured with a tibial interference screw and to evaluate the effect of different screw diameters (7, 8, and 9 mm) and lengths (25 and 30 mm) on the force in these grafts. Study Design: Controlled laboratory study. Methods: Quadruple-strand flexor tendon grafts were fixed with bioabsorbable interference screws in 60 porcine tibiae. Grafts were pretensioned at 80 N over 10 minutes, and screws were inserted outside-in while a preload force of 80 N was applied. Different screw lengths (25 and 30 mm) and diameters (7, 8, and 9 mm), resulting in 6 groups with 10 specimens each, were tested. After release of the preload, graft force was recorded over 24 hours. Results: A significant decrease in graft force progressed in all groups over the 24-hour period. In total, a median loss of 75 N (IQR, 68-79 N) compared with the initial loading force was observed. Compared with the loading force of 80 N, this corresponded to a median loss of 91%. No significant differences in the remaining graft force could be found among the 6 different screw length and diameter groups after 10 minutes, 100 minutes, or 24 hours. Conclusion: Graft force in soft tissue grafts secured with a tibial interference screw decreased substantially over the first 24 hours after fixation. Neither the screw diameter nor the screw length affected the decrease in graft force. This raises substantial questions regarding the remaining fixation strength in vivo. Clinical Relevance: It should not be expected that ACL reconstruction can mechanically restabilize an injured knee as would an intact ACL. Reconstructed knees should be protected from mechanical overload in the early postoperative period.

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CLINICAL COMPARISON BETWEEN FEMORAL TRANSFIXATION AND BIOSCREW FIXATION USING HAMSTRING TENDON GRAFT FOR ACL RECONSTRUCTION AT ORTHOPAEDICS DEPARTMENT OF JLNMCH, BHAGALPUR, BIHAR

10.36106/ijsr/4026688 ◽

2020 ◽

pp. 65-67

Author(s):

Rakesh Ramdayal Singh ◽

Yogesh Kumar ◽

Maseeh Azam ◽

D. K. Singh ◽

Debarshi Jana

Keyword(s):

Acl Reconstruction ◽

Femoral Condyle ◽

Knee Laxity ◽

Hamstring Tendon ◽

Tendon Graft ◽

Interference Screw ◽

Fixation Technique ◽

Significant Difference ◽

Hamstrings Tendon ◽

Femoral Side

Background: One of the popular graft choices for ACL reconstruction have been Hamstrings tendon autograft. Thereis no consensus on the ideal technique of fixation of hamstrings graft to femoral condyle. Theoretically we hypothesized that transfixation method of hamstrings graft fixation to femoral condyle should be superior to bio-interference screw fixation technique. Hence aim of our study is to compare this two fixation methods of hamstrings autografts clinically. Methods: 50 clinically and radiologically proven ACL deficient fighting soldiers are selected for the study. In groupA; 25 patients underwent ACL reconstruction with Bioscrew using aperture technique on femoral side. Other 25 patients in group B underwent ACL reconstruction with transfixation screw using cortico-cancellous fixation technique on femoral side. In both groups quadrupled semitendinosus autograft is utilized. All the patients evaluated for functional outcome at the end of 6 weeks and at 6 months and at the end of 1 year following the procedure. The subjects are evaluated using the modified Lysholm knee score and knee laxity is measured by Rolimeter. Results: At 01 year post op. there was no statistically significant difference in both groups in terms of Manual laitytests,Rollimeter laity measurement and Lysholm knee score.The overall satisfactory result (Excellent + Good) in both the groups at 01 year follow up were 98% by Lysholm score. Conclusions: Transfixation and Bioscrew fixation showed comparable results in manual knee laxity tests,instrumental knee laxity tests using Rolimeter, Lyslohm scores and high patient satisfaction, with almost 96% of patients in both groups returned to their pre-injury levels.

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A Prospective Comparative Study Correlating the Efficacy of Biodegradable versus Metallic Interference Screw for Tibial Sided Anterior Cruciate Ligament Reconstruction - A Unicentre Pilot Study in Jaipur, Rajasthan

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/241 ◽

2021 ◽

Vol 8 (18) ◽

pp. 1258-1263

Author(s):

Vishal Singh ◽

Alokeshwar Sharma ◽

Avinash Gundavarapu ◽

Tejas Patel ◽

Santosh Kumar M

Keyword(s):

Anterior Cruciate Ligament ◽

Comparative Study ◽

Acl Reconstruction ◽

Cruciate Ligament ◽

Interference Screw ◽

Single Bundle ◽

Interference Screws ◽

Prospective Comparative Study ◽

Anterior Cruciate ◽

Screw Group

BACKGROUND Traditionally, metallic interference screws were considered to have increased resistance to load than bio absorbable screws in anterior cruciate ligament (ACL) reconstruction. We did a comparative evaluation of biodegradable and metallic interference screws for tibial sided ACL reconstruction and also analysed complications, compared clinical outcome, did imaging study of ACL single bundle reconstruction by using titanium & newer poly–L-lactic acid (PLLA) bio absorbable screws to determine as to whether bio absorbable screw which costs double the metallic screw, is functionally better than standard metallic screws. METHODS This is a prospective comparative study conducted among 50 patients aged between 15 and 55 years with clinical and MRI confirmation of complete ACL tear, treated arthroscopically with ACL reconstruction with either bio absorbable (group 1) or metallic (group 2) interference screw and both the groups were compared on follow up for an average duration of 12 months. Lysholm and Gillquist Knee Scoring Scale were used and outcome scores were divided into excellent, good, fair and poor. RESULTS In our study 41 patients were males and 9 were females. Bio screw was used in 24 males and 6 female patients. Metallic screw was used in 17 males and 3 females. Outcome score was excellent in 26 (52 %) cases, good in 18 (36 %) cases, fair in 4 (8 %) cases, poor in 2 (4 %) cases. The mean Lysholm score in bio absorbable group was 93.13 and in metallic group was 89.70. Knee effusion was higher in bio screw group and infection rate was higher in metallic group. CONCLUSIONS In our study, the difference between bio absorbable screw group and metallic screw group was insignificant with regard to final patient outcome. Final osseointegration was better with bio absorbable screw, but increased cost of implant and almost same results compared to metallic screw does not make the bio absorbable screw superior to its counterpart. KEYWORDS ACL, Bio Absorbable Interference Screws, Metallic Interference Screws

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BONE TUNNEL ENLARGEMENT WITH NON-METALLIC INTERFERENCE SCREWS IN ACL RECONSTRUCTION

Acta Ortopédica Brasileira ◽

10.1590/1413-785220182605199995 ◽

2018 ◽

Vol 26 (5) ◽

pp. 305-308 ◽

Cited By ~ 1

Author(s):

Vitor Barion Castro de Padua ◽

Júlio Cesar Rodrigues Vilela ◽

Wendel Aculha Espindola ◽

Rafael Cassiolato Garcia Godoy

Keyword(s):

Acl Reconstruction ◽

Femoral Tunnel ◽

Tibial Tunnel ◽

Bone Tunnel ◽

Tunnel Enlargement ◽

Interference Screws ◽

Bone Tunnel Enlargement ◽

Reconstruction Methods ◽

Significant Difference ◽

Bone Tunnels

ABSTRACT Objective: To compare the widening of bone tunnels between poly-etheretherketone (PEEK), absorbable polylactic acid DL (PLDL) and tricalcium phosphate (TCP) interference screws in anterior cruciate ligament (ACL) reconstruction. Methods: Three groups of patients undergoing ACL reconstruction with at least 1 year of follow-up using the out-in drilling technique and hamstring as a graft were assessed. The patients were divided according to the type of interference screw used (PEEK, PLDL and TCP). Computed tomography (CT) was performed to measure the greatest femoral and tibial tunnel widening regarding to the initial tunnel, and then it was compared between groups. Results: Mean widening in group 1 (PEEK) was 39.56% (SD 16%) in the femoral tunnel and 33.65% (SD 20%) in the tibia. In group 2 (PLDL) mean widening was 48.43% in the femoral tunnel (SD 18%) and 35.24% (SD 13%) in the tibial tunnel. In group 3 (TCP) mean widening was 44.51% in the femur (SD 14%) and 36.83% in the tibia (SD 14%). The comparison between groups (PLDL-PEEK, PLDL-TCP, PEEK-TCP) shows no statistically significant difference. Conclusion: Bone tunnel enlargement values after ACL reconstruction with the use of different types of materials (bioinert and biomaterials) of interference screws (PEEK, PLDL and TCP) were similar. Level of Evidence III, Comparative retrospective study.

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