Skip to main content

Advertisement

Log in

Suspensory fixation versus novel transverse crosspin for femoral fixation in anterior cruciate ligament reconstruction

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

Abstract

Background and aim

There is still no gold standard technique for graft fixation during anterior cruciate ligament reconstruction. We compared the functional outcomes of patients receiving either ToggleLoc with ZipLoop technology or Translig transverse crosspin device for femoral graft fixation.

Materials and methods

A total of 118 patients were randomly allocated into two groups to receive either Translig® transverse crosspin (Translig group 1: n = 51, mean age 28.34 ± 7.83 years, age 18–40 years) or ToggleLoc with ZipLoop technology (ToggleLoc group: n = 67, mean age 26.85 ± 8.76, age 16-41 years) for femoral graft fixation. Early and 1-year assessment was made with Lysholm knee scale, International Knee Documentation Committee Scoring, Tegner Activity Level Scale, KT-1000 arthrometer and pivot shift test.

Results

Preoperative vs. postoperative functional parameters showed significant improvement in both groups. Two groups were similar in terms of Lysholm knee scale, IKDC and Tegner activity scores (p > 0.05). The KT-1000 arthrometer revealed slightly less anterior sliding in Translig group than that in ToggleLoc group (p > 0.05). ToggleLoc technique allowed a radiographically more horizontal placement of the graft than Translig technique.

Conclusion

Two distinct techniques used in this study are likely to be suitable for femoral graft fixation during anterior cruciate ligament reconstruction with the femoral tunnel being created via anteromedial approach.

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. Moses B, Orchard J, Orchard J (2012) Systematic review: annual incidence of ACL injury and surgery in various populations. Res Sports Med 20(3–4):157–179

    PubMed  Google Scholar 

  2. Spindler KP, Parker RD, Andrish JT, Kaeding CC, Wright RW, Marx RG et al (2013) Prognosis and predictors of ACL reconstructions using the MOON cohort: a model for comparative effectiveness studies. J Orthop Res 31:2–9

    Article  PubMed  PubMed Central  Google Scholar 

  3. Mohtadi NG, Chan DS, Dainty KN, Whelan DB (2011) Patellar tendon versus hamstring tendon autograft for anterior cruciate ligament rupture in adults. Cochrane Database Syst Rev (9):CD005960

    Google Scholar 

  4. Firat A, Catma F, Tunc B, Hacihafizoglu C, Altay M, Bozkurt M et al (2014) The attic of the femoral tunnel in anterior cruciate ligament reconstruction: a comparison of outcomes of two suspensory femoral fixation systems. Knee Surg Sports Traumatol Arthrosc 22:1097–1105

    Article  PubMed  Google Scholar 

  5. Rylander L, Brunelli J, Taylor M, Baldini T, Ellis B, Hawkins M et al (2014) A biomechanical comparison of anterior cruciate ligament suspensory fixation devices in a porcine cadaver model. Clin Biomech (Bristol, Avon) 29:230–234

    Article  Google Scholar 

  6. Eguchi A, Ochi M, Adachi N, Deie M, Nakamae A, Usman MA (2014) Mechanical properties of suspensory fixation devices for anterior cruciate ligament reconstruction: comparison of the fixed-length loop device versus the adjustable-length loop device. Knee. doi:10.1016/j.knee.2014.02.009

  7. Gifstad T, Drogset JO, Grøntvedt T, Hortemo GS (2013) Femoral fixation of hamstring tendon grafts in ACL reconstructions: the 2-year follow-up results of a prospective randomized controlled study. Knee Surg Sports Traumatol Arthrosc (Epub ahead of print)

  8. Firat A, Catma F, Tunc B, Hacihafizoglu C, Altay M, Bozkurt M, Kapicioglu MI (2014) The attic of the femoral tunnel in anterior cruciate ligament reconstruction: a comparison of outcomes of two suspensory femoral fixation systems. Knee Surg Sports Traumatol Arthrosc 22:1097–1105

    Article  PubMed  Google Scholar 

  9. Nebelung S, Deitmer G, Gebing R, Reichwein F, Nebelung W (2012) Anterior cruciate ligament reconstruction using biodegradable transfemoral fixation at 5-year follow-up: clinical and magnetic resonance imaging evaluation. Knee Surg Sports Traumatol Arthrosc 20:2279–2286

    Article  PubMed  Google Scholar 

  10. Kruse LM, Gray B, Wright RW (2012) Rehabilitation after anterior cruciate ligament reconstruction: a systematic review. J Bone Joint Surg Am 94(19):1737–1748

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  11. Lee JJ, Otarodifard K, Jun BJ, McGarry MH, Hatch GF 3rd, Lee TQ (2011) Is supplementary fixation necessary in anterior cruciate ligament reconstructions? Am J Sports Med 39:360–365

    Article  PubMed  Google Scholar 

  12. Colvin A, Sharma C, Parides M, Glashow J (2011) What is the best femoral fixation of hamstring autografts in anterior cruciate ligament reconstruction? A meta-analysis. Clin Orthop Relat Res 469:1075–1081

    Article  PubMed  PubMed Central  Google Scholar 

  13. Petre BM, Smith SD, Jansson KS, de Meijer PP, Hackett TR, LaPrade RF 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 

  14. Conner CS, Perez BA, Morris RP, Buckner JW, Buford WL Jr, Ivey FM (2010) Three femoral fixation devices for anterior cruciate ligament reconstruction: comparison of fixation on the lateral cortex versus the anterior cortex. Arthroscopy 26:796–807

    Article  PubMed  Google Scholar 

  15. Silva A, Sampaio R, Fernandes R, Pinto E (2014) Is there a role for adult non-cultivated bone marrow stem cells in ACL reconstruction? Knee Surg Sports Traumatol Arthrosc 22:66–71

    Article  PubMed  Google Scholar 

  16. Dorozhkin SV (2011) Biocomposites and hybrid biomaterials based on calcium orthophosphates. Biomatter 1(1):3–56. doi:10.4161/biom.1.1.16782

    Article  PubMed  PubMed Central  Google Scholar 

  17. Asik M, Sen C, Tuncay I, Erdil M, Avci C, Taser OF (2007) The mid- to long-term results of the anterior cruciate ligament reconstruction with hamstring tendons using Transfix technique. Knee Surg Sports Traumatol Arthrosc 15:965–972

    Article  PubMed  Google Scholar 

  18. Nebelung S, Deitmer G, Gebing R, Reichwein F, Nebelung W (2012) Anterior cruciate ligament reconstruction using biodegradable transfemoral fixation at 5-year follow-up: clinical and magnetic resonance imaging evaluation. Knee Surg Sports Traumatol Arthrosc 20:2279–2286

    Article  PubMed  Google Scholar 

  19. Choi NH, Son KM, Yoo SY, Victoroff BN (2012) Femoral tunnel widening after hamstring anterior cruciate ligament reconstruction with bioabsorbable transfix. Am J Sports Med 40:383–387

    Article  PubMed  Google Scholar 

  20. Sawyer GA, Anderson BC, Paller D, Heard WM, Fadale PD (2013) Effect of interference screw fixation on ACL graft tensile strength. J Knee Surg 26:155–159

    PubMed  Google Scholar 

  21. Barrow AE, Pilia M, Guda T, Kadrmas WR, Burns TC (2014) Femoral suspension devices for anterior cruciate ligament reconstruction: do adjustable loops lengthen? Am J Sports Med 42:343–349

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

None declared.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Sinan Zehir.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zehir, S., Zehir, R. Suspensory fixation versus novel transverse crosspin for femoral fixation in anterior cruciate ligament reconstruction. Arch Orthop Trauma Surg 134, 1579–1585 (2014). https://doi.org/10.1007/s00402-014-2062-0

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00402-014-2062-0

Keywords

Navigation