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Anterior cruciate ligament reconstruction using autografts and double biodegradable femoral cross-pin fixation: functional, radiographic and MRI outcome after 2-year minimum follow-up

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

Abstract

Double biodegradable cross-pins are increasingly used for femoral fixation in arthroscopically assisted reconstruction of the anterior cruciate ligament (ACL). There are no studies combining functional outcome analysis, radiographs and magnetic resonance images (MRI) to evaluate this technique. The authors examined 45 patients after ACL reconstruction using double biodegradable femoral cross-pin fixation and biodegradable tibial interference screw fixation with a minimum follow-up of 24 months. Clinical evaluation included International Knee Documentation Committee (IKDC) and modified Lysholm score. Radiographic analysis included standard X-rays in anterior–posterior and lateral views and Telos stress device measurements. MRI was analyzed to obtain information about hardware, intra-articular graft, osseous graft-integration and cartilage. IKDC score revealed 28 (62.2%) patients with normal knee function (group A), 15 (33.3%) patients with nearly normal (group B) knee function and 2 (4.4%) patients with abnormal knee function (group C). The Lysholm score was 94.6 (±7.2) in the operated knee and 98.8 (±7.4) in the non-operated knee. Mean Telos stress device values were +4.6 (±2.6) in the operated and +3.9 (±2.4) in the non-operated knee. MRI showed an intact intra-articular graft in all but one patient. Complete femoral graft integration was seen in 88.9% and complete tibial graft integration in 86.7%. Biodegradable cross-pins were partially or fully visible in all patients. The biodegradable tibial interference screw was fully visible in 16 (35.6%) and partially visible in 20 (44.4%) patients. Thirty-one (68.9%) patients showed signs of cartilage degeneration on MRI at follow-up. The graft fixation with double biodegradable pin fixation appears to be a reliable technique for ACL reconstruction providing a stable close-to-joint graft fixation.

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Acknowledgments

This study could not have been conducted without the grant provided by the Austrian Workers’ Compensation Board number 28/06. We thank Gerhard Netzker, radiological assistant, for his support during radiographic and MRI examination series. Furthermore, we are greatly indebted to Linda E. Pelinka, MD, PhD, and Sarah Zifko, BA, for their valuable help with the language of the manuscript. P·W. wishes to dedicate this paper to his fiancée Veronica for her unwavering support and encouragement.

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  1. Trauma Hospital “Lorenz Boehler”, Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, Donaueschingenstrasse 13, 1200, Vienna, Austria

    Patrick Weninger, Benno Zifko, Michael Liska, Ralf Spitaler, Hartmut Pelinka & Harald Hertz

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  1. Patrick Weninger
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  2. Benno Zifko
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  3. Michael Liska
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Correspondence to Patrick Weninger.

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Weninger, P., Zifko, B., Liska, M. et al. Anterior cruciate ligament reconstruction using autografts and double biodegradable femoral cross-pin fixation: functional, radiographic and MRI outcome after 2-year minimum follow-up. Knee Surg Sports Traumatol Arthr 16, 988–995 (2008). https://doi.org/10.1007/s00167-008-0585-z

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