Functional outcome of arthroscopic ACL reconstruction using titanium interference screw against biodegradable screw and sheath device for tibial side graft fixation - A study of 140 pts - http://jocponline.com
IJOCP | April 2014 | Volume 1 | Issue 2 | Page 5 Conference: Poona Orthopaedic Society Annual Conference POSAC- 2014, India[Click for Full details]
Background Context–The management of the anterior cruciate ligament deficient knee has developed dramatically during the past decades. The intra-articular reconstruction with a biologic graft is currently the procedure of choice for the treatment of a rupture of the ACL. Many factors influence the clinical success of the ACL reconstruction, including the graft material itself, the fixation of the graft, the placement of the graft, and the rehabilitation after the reconstruction. The improvements in the fixation methods, enabling the use of multiple strand hamstring grafts and the relatively low donor-site morbidity have resulted in the increased popularity of the hamstring graft. However, the concerns associated with the use of the hamstring tendon graft include the failure to achieve rigid initial fixation to bone, and slower bone tunnel incorporation. Graft fixation site is the weakest link in the ACL reconstruction during the immediatepostoperative period until biologic fixation occurs. ACL graft fixation is commonly considered more problematic at the tibia compared to femur. Many methods of graft fixation have been used, including staples, sutures over a screw post, sutures tied to a button, polyester tape-titanium button, screws and washers, transfixations, and interference screws of various designs, materials and sizes. Although numerous soft tissue tibial tunnel fixation devices exist, few studies have compared their biomechanical properties. Current research lacks a thorough analysis and comparison of interference screws and combination screw and sheath devices. The purpose of this study was to compare functional outcome of arthroscopic ACL reconstruction using titanium interference screws versus biodegradable screw and sheath devices for intratunnel tibial soft tissue fixation.
Material and Method :Patients in age group 18 to 50 with ACL tear were randomly allocated for arthroscopic ACL reconstruction with tibial fixation either by titanium interference screw or centrally placed screw and sheath. We have studied 70 pts in each group who have completed 1 yr follow up. For all patients autologous quadrupled semi T and grasilis was used as a graft. Post operatively patient are given long leg knee brace for three week and hinge knee brace for the next two months. Patients are examined at the end of two weeks, six weeks, three months, six months and then at the end of one year. Patients are allowed to resume their normal sports activity after six to eight months. Patients were evaluated preoperatively and postoperatively for pain, range of motion (ROM), pivot shift test, lachman test, anterior drawer test ,International Knee Documentation Committee (IKDC) and lyshlom knee scoring system.
Result and Conclusion: At the end of first year post op we found no statistical difference in form of IKDC score Lysohlm score and Maximal distance at latchman test. We found increased surface area of graft to bone tunnel increases the possibility of strong incorporation of graft as compared to eccentric graft placement in titanium screw group.
How to Cite this Abstract
Dixit. Functional outcome of arthroscopic ACL reconstruction using titanium interference screw against biodegradable screw and sheath device for tibial side graft fixation – A study of 140 pts. I J Orthopaedic Conference Proceedings April 2014;1(2):5.