Clinical Comparison of Transfix and Tightrope Fixations in Patients with Arthroscopic Anterior Cruciate Ligament Reconstruction

Backgraound: Transfix and Tightrope are widely used devices for femoral graft fixation in arthroscopic anterior cruciate ligament (ACL) reconstruction. The purpose of the study is to reveal differences between Transfix and Tightrope fixation technique by evaluating clinical results of cases. Materials and Methods: 87 patients who underwent arthroscopic ACL reconstruction for ACL rupture between January 2013 and June 2017 by the same senior surgeon and in whom the fixation methods evaluated in this study had been employed were retrospectively reviewed. Transfix was used in 45 (52%) patients and ACL Tightrope was used in 42 (48%) patients. In the first group (Transfix) mean age was 26,3± 5.8 (18-45) second group (Tightrope) mean age was 26,7± 6.1 (17-46). Patients in both groups were retrospectively screened for anamnesis and physical examination records in the hospital registry system. In addition, IKDC(International Knee Documentation Committee) and Lysholm scores were calculated in the preoperative and postoperative follow-up period, and all findings were evaluated over a mean period of 42.5 ± 7.4 (24-54) months. Results: Clinical evaluation and stability tests indicated that statistically no significant difference found between two groups. For the first group preoperative Lysholm scores was 47,3 and postoperatively 93 and second group scores were respectivly 47,6 and 94 (P<0.05). IKDC scoring system for first group preoperatively there were 13 poor, 26 good and 6 fair knees ; postoperatively 2 fair, 27 good and 16 excellent .In the second group preoperatively 11 poor, 25 fair and 6 good knees and postoperatively 2 fair, 26 good and 14 excellent knees evaluated. Conclucions: In ACL reconstruction for fixation femoral graft, Transfix and Tightrope are frequently used implants. Therefore, both femoral fixation implants can be safely used in arthroscopic ACL reconstruction based on the experience and preference of the surgeon, provided that they are properly applied.

Complications following Suture Button Use for Femoral Graft Fixation in Arthroscopic Anterior Cruciate Ligament Reconstruction: A Systematic Review

Understanding any potential complications that may occur in relation to the use of a suture button for femoral graft fixation in arthroscopic anterior cruciate ligament reconstruction can help raise awareness among surgeons and improve safety when using such implants. This is a systematic review of suture button related complications. A literature search was conducted using the PubMed, Embase, and CINAHL (Cumulative Index to Nursing and Allied Health Literature) databases from their year of inception until January 3, 2019. We included studies reporting on suture button related complications in their outcomes of femoral graft suture button fixation in anterior cruciate ligament reconstruction. Our search identified 479 articles, of which 19 met our inclusion criteria. Suture button misplacement (initial or subsequent migration) was the most commonly reported complication. Although, in most cases, button misplacement is minimal and does not adversely affect clinical outcomes, in some cases it may lead to graft failure or local soft tissue irritation and require further surgery. Intraoperative screening or arthroscopic evaluation of the deployed suture button may reduce this complication.