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A randomized prospective controlled study with 5-year follow-up of cross-pin femoral fixation versus metal interference screw fixation in anterior cruciate ligament reconstruction

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The purpose of this study was to determine and compare mid- to long-term results of cross-pin versus metal interference screw fixation of ACL graft.

Methods

In a prospective trial, 62 patients were randomized into two groups based on method of fixation. Transtibial drilling technique was used in the cross-pin and outside-in femoral drilling in the interference screw fixation group. Clinical and radiographical outcomes were assessed 2 and 5 years postoperatively.

Results

The study showed no clinically significant difference with respect to method of graft fixation. Mean anteroposterior side-to-side instrumented laxity difference was 2.4 mm in the cross-pin group and 2.5 mm in the screw group (n.s.). Median Tegner and mean Lysholm scores at 5 years were 6 (range 3–9) and 92.2 (range 69–100) in the screw group and 7 (3–10) and 93.3 (82–100), respectively, in the cross-pin group. Radiographical osteoarthritis increased in both groups from 2 to 5 years after reconstruction (p < 0.05), especially in the medial and patellofemoral joint spaces. Widening of the drill tunnels continued from 2 to 5 years without clinical significance.

Conclusions and clinical relevance

The method of graft fixation did not yield a difference in clinical or radiographical outcome at 5 years. Results were excellent in both groups.

Level of evidence

I.

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Authors and Affiliations

  1. Helsinki University Central Hospital, Helsinki, Finland

    Patrick Björkman

  2. ORTON Orthopaedic Hospital, Helsinki, Finland

    Jerker Sandelin & Arsi Harilainen

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  1. Patrick Björkman
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  2. Jerker Sandelin
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  3. Arsi Harilainen
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Correspondence to Patrick Björkman.

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Björkman, P., Sandelin, J. & Harilainen, A. A randomized prospective controlled study with 5-year follow-up of cross-pin femoral fixation versus metal interference screw fixation in anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 23, 2353–2359 (2015). https://doi.org/10.1007/s00167-014-3063-9

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  • DOI: https://doi.org/10.1007/s00167-014-3063-9

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