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

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomedical Engineering

Background:

• Bone-patellar tendon-bone (BPTB) autografts are a gold standard for anterior cruciate ligament (ACL) reconstruction.
• Interference screw fixation is the traditional method for securing BPTB grafts.

Purpose of the Study:

• To compare the efficacy of press-fit fixation versus interference screw fixation for BPTB autografts in ACL reconstruction.
• To evaluate outcomes at a 12-month follow-up interval.

Main Methods:

• A prospective, randomized clinical trial involving 158 patients with ACL tears.
• Patients underwent ACL reconstruction using BPTB autografts, with 82 receiving press-fit fixation and 76 receiving interference screw fixation.
• Outcomes assessed included return to activity, pain, knee stability, range of motion, IKDC scores, and complications.

Main Results:

• Both press-fit and interference screw groups showed comparable good-to-excellent IKDC scores (83% vs. 85%).
• Knee laxity improved similarly in both groups (2.7 mm vs. 2.5 mm).
• No significant differences were observed in Lachman/pivot shift tests, pain, range of motion, or complications between the fixation methods.

Conclusions:

• Press-fit fixation is an effective alternative for securing BPTB autografts in ACL reconstruction.
• Outcomes of press-fit fixation are comparable to interference screw fixation.
• Press-fit offers potential benefits including unlimited bone-to-bone healing, no hardware removal, easier revision, and cost-effectiveness.