Skip to main content

Advertisement

Log in

Cortical femoral suspensory fixation using screw post in anatomic single-bundle anterior cruciate ligament reconstruction: a prospective study and mid-term outcome results

  • Original Paper
  • Published:
International Orthopaedics Aims and scope Submit manuscript

Abstract

Purpose

Cortical femoral suspensory fixation using screw post in ACLR has the advantage of allowing complete filling of the femoral tunnel with graft tissue. In addition, the low cost of the implants is an advantage in countries where cost is an issue of concern. The purpose of the current study was to evaluate the clinical functional outcome results of cortical femoral suspensory fixation using screw post at mid-term follow-up.

Methods

Single surgeon single centre prospective case series study. Sixty two patients having complete ACL tears were included in the current study. Average follow-up was 52.6 months (range 38–68). Objective and subjective IKDC scores, Lysholm knee score, SF-36 score, VAS for patients’ satisfaction, VAS for pain and Kellgren & Lawrence (K/L) classification of osteoarthritis were used for follow-up evaluation.

Results

Objective IKDC score revealed that 59 patients had grade “A” and 3 had grade “B”, while no single patient had neither grade “C” nor “D”. The average Lysholm score was 90.7, average subjective IKDC was 89.5. Average SF-36 score was 94.8. The average VAS for operation satisfaction was 9.4. Average VAS for pain was 0.2. Forty six patients were classified as normal K/L classification, nine were grade “1”, seven were grade “2”. Comparing pre-operative and follow-up objective IKDC, subjective IKDC, Lysholm, SF-36, and VAS for pain scores revealed statistically significant differences (P-value <0.05).

Conclusion

Femoral suspensory fixation using screw post in ACLR showed excellent functional outcome results at mid-term follow-up.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Ahmad CS, Gardner TR, Groh M et al (2004) Mechanical properties of soft tissue femoral fixation devices for anterior cruciate ligament reconstruction. Am J Sports Med 32(3):635–640

    Article  PubMed  Google Scholar 

  2. Matsumoto A, Yoshiya S, Muratsu H et al (2006) A comparison of bone patellar tendon-bone and bone-hamstring tendon-bone autografts for anterior cruciate ligament reconstruction. Am J Sports Med 34(2):213–219

    Article  PubMed  Google Scholar 

  3. Taylor DC, DeBerardino TM, Nelson BJ et al (2009) Patellar tendon versus hamstring tendon autografts for anterior cruciate ligament reconstruction: a randomized controlled trial using similar femoral and tibial fixation methods. Am J Sports Med 37(10):1946–1957

    Article  PubMed  Google Scholar 

  4. Ntagiopoulos PG, Demey G, Tavernier T, Dejour D (2015) Comparison of resorption and remodeling of bioabsorbable interference screws in anterior cruciate ligament reconstruction. Int Orthop 39(4):697–706

    Article  PubMed  Google Scholar 

  5. Scheffler SU, Sudkamp NP, Gockenjan A et al (2002) Biomechanical comparison of hamstring and patellar tendon graft anterior cruciate ligament reconstruction techniques: the impact of fixation level and fixation method under cyclic loading. Arthroscopy 18:304–315

    Article  PubMed  Google Scholar 

  6. Stadelmaier DM, Lowe WR, Ilahi OA et al (1999) Cyclic pullout strength of hamstring tendon graft fixation with soft tissue interference screws: influence of screw length. Am J Sports Med 27(6):778–783

    CAS  PubMed  Google Scholar 

  7. Choi NH, Lee JH, Victoroff BN (2007) Do broken cross-pins compromise stability after anterior cruciate ligament reconstructions with hamstring tendons? Arthroscopy 23(12):1334–1340

  8. Petre BM, Smith SD, Jansson KS et al (2013) Femoral cortical suspension devices for soft tissue anterior cruciate ligament reconstruction: a comparative biomechanical study. Am J Sports Med 41(2):416–422

    Article  PubMed  Google Scholar 

  9. Takeda Y, Iwame T, Takasago T et al (2013) Comparison of tunnel orientation between transtibial and anteromedial portal techniques for anatomic double-bundle anterior cruciate ligament reconstruction using 3-dimensional computed tomography. Arthroscopy 29(2):195–204

    Article  PubMed  Google Scholar 

  10. Kellgren JH, Lawrence JS (1957) Radiological assessment of osteoarthrosis. Ann Rheum Dis 16:494–501

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Hefti F, Müller W, Jakob RP et al (1993) Evaluation of knee ligament injuries with the IKDC form. Knee Surg Sports Traumatol Arthrosc 1:226–234

    Article  CAS  PubMed  Google Scholar 

  12. Tegner Y, Lysholm J (1985) Rating systems in the evaluation of knee ligament injuries. Clin Orthop 198:43–49

    PubMed  Google Scholar 

  13. Kalantar-Zadeh K, Kopple JD, Block G et al (2001) Association among SF-36 quality of life measures and nutrition, hospitalization and mortality in hemodialysis. J Am Soc Nephrol 12(12):2797–2806

    CAS  PubMed  Google Scholar 

  14. Karlsson J, Irrgang JJ, van Eck CF et al (2011) Anatomic single- and double-bundle anterior cruciate ligament reconstruction, part 2: clinical application of surgical technique. Am J Sports Med 39:2016–2026

  15. Abdelkafy A (2012) Protection of the medial femoral condyle articular cartilage during drilling of the femoral tunnel through the accessory medial portal in anatomic anterior cruciate ligament reconstruction. Arthrosc Tech 1(2):e149–e154

    Article  PubMed  PubMed Central  Google Scholar 

  16. Andrei BI, Niculescu M, Popescu G (2015) Position of anterior cruciate ligament after single-bundle arthroscopic reconstruction. Int Orthop. doi:10.1007/s00264-015-2964-7

    Google Scholar 

  17. Ambra LF, Rezende FC, Xavier B, Shumaker FC, da Silveira Franciozi CE, Luzo MV (2015) Anterior cruciate ligament reconstruction: how do we perform it? Brazilian orthopedic surgeons’ preference. Int Orthop. doi:10.1007/s00264-015-2905-5

    PubMed  Google Scholar 

  18. Mouzopoulos G, Siebold R, Tzurbakis M (2015) Hip flexion strength remains decreased in anterior cruciate ligament reconstructed patients at one-year follow up compared to healthy controls. Int Orthop 39(7):1427–1432

    Article  PubMed  Google Scholar 

  19. Shabani B, Bytyqi D, Lustig S, Cheze L, Bytyqi C, Neyret P (2015) Gait knee kinematics after ACL reconstruction: 3D assessment. Int Orthop 39(6):1187–1193

    Article  PubMed  Google Scholar 

  20. Rodeo SA, Arnocky SP, Torzilli PA et al (1993) Tendon healing in a bone tunnel: a biomechanical and histological study in the dog. J Bone Joint Surg Am 75(12):1795–1803

    CAS  PubMed  Google Scholar 

  21. Wascher DC, Markolf KL, Shapiro MS et al (1993) Direct in vitro measurement of forces in the cruciate ligaments, part 1: the effect of muliplane loading in the intact knee. J Bone Joint Surg Am 75:377–386

    CAS  PubMed  Google Scholar 

  22. Sundararajan SR, Rajagopalakrishnan R, Rajasekaran S (2015) Is height the best predictor for adequacy of semitendinosus-alone anterior cruciate ligament reconstruction? A study of hamstring graft dimensions and anthropometric measurements. Int Orthop. doi:10.1007/s00264-015-2882-8

    PubMed  Google Scholar 

  23. Miyata K, Yasuda K, Kondo E et al (2000) Biomechanical comparisons of anterior cruciate ligament reconstruction procedures with flexor tendon graft. J Orthop Sci 5:585–592

    Article  CAS  PubMed  Google Scholar 

  24. Barrow AE, Pilia M, Guda T et al (2014) Femoral suspension devices for anterior cruciate ligament reconstruction: do adjustable loops lengthen? Am J Sports Med 42(2):343–349

    Article  PubMed  Google Scholar 

  25. Brucker PU, Lorenz S, Imhoff AB (2006) Aperture fixation in arthroscopic anterior cruciate ligament double-bundle reconstruction. Arthroscopy 22(11):1250.e1–1250.e6

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ashraf Abdelkafy.

Ethics declarations

Authors certify that all procedures performed in the current study involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Conflict of interest

None.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Abdelkafy, A. Cortical femoral suspensory fixation using screw post in anatomic single-bundle anterior cruciate ligament reconstruction: a prospective study and mid-term outcome results. International Orthopaedics (SICOT) 40, 1741–1746 (2016). https://doi.org/10.1007/s00264-015-3091-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-015-3091-1

Keywords

Navigation