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ACL reconstruction using bone–patella tendon–bone autograft: press-fit technique vs. interference screw fixation

  • Arthroscopy and Sports Medicine
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Purpose

The gold standard in ACL reconstructions has been the bone–patellar tendon–bone autograft fixed with interference screws. This prospective, randomized clinical trial aimed to compare two methods of fixation for BPTB grafts: press-fit fixation vs. interference screw, over a 12-month follow-up interval.

Methods

158 patients with an average age of 29.8 years, between 2011 and 2012, were treated for torn ACL. 82 patients underwent reconstruction with BPTB autograft with a press fit fixation technique, and in 76 cases an interference screw was used. At the time of final follow-up, 71 patients in press-fit group and 65 patients in interference screw group were evaluated in terms of return to pre-injury activity level, pain, knee stability, range of motion, IKDC score and complications.

Results

At 12-month follow-up, 59 (83 %) and 55 (85 %) in press-fit and screw group, respectively had good-to-excellent IKDC score (p > 0.05). The mean laxity assessed using a KT-1000 arthrometer improved to 2.7 and 2.5 mm in press-fit and screw group, respectively. Regarding Lachman and pivot shift test, there was a statistically significant improvement in the integrity of the ACL in both the groups, but no significant differences was noted between groups. There were no significant differences in terms of femur circumference difference, effusion, knee range of motion, pain and complications.

Conclusions

The press-fit technique is an efficient procedure. Its outcome was comparable with the interference screw group. Furthermore it has unlimited bone-to-bone healing, no need for removal of hardware, ease for revision and cost effectiveness.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    M. M. Sarzaeem & F. Najafi

  2. Department of Orthopaedic and Sport Medicine, Rassole Akram Hospital, Iran University of Medical Sciences, Tehran, Iran

    M. Razi

  3. Faculty of Medicine, Isfahan University of Medical Sciences, Esfahan, Iran

    M. A. Najafi

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  1. M. M. Sarzaeem
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  2. F. Najafi
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Correspondence to F. Najafi.

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Sarzaeem, M.M., Najafi, F., Razi, M. et al. ACL reconstruction using bone–patella tendon–bone autograft: press-fit technique vs. interference screw fixation. Arch Orthop Trauma Surg 134, 955–962 (2014). https://doi.org/10.1007/s00402-014-1999-3

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  • DOI: https://doi.org/10.1007/s00402-014-1999-3

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