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Does adjustable-loop femoral cortical suspension loosen after anterior cruciate ligament reconstruction? A
Matthew J Boyle1, Tyler J Vovos1, Cameron G Walker2
1Duke Sports Medicine, Department of Orthopaedic Surgery, Duke University Medical Center, 280 Frank Bassett Drive, Durham, NC 27710, USA.
Background:
Recent biomechanical research has suggested that adjustable-loop graft suspension constructs in anterior cruciate ligament (ACL) reconstruction may loosen after deployment. Our objective was to compare short-term knee stability and graft failure rate between adjustable-loop and fixed-loop femoral cortical suspension in patients undergoing primary ACL reconstruction.
Methods:
A consecutive series of 188 patients who underwent primary ACL reconstruction using hamstrings autograft by a single surgeon were divided into two groups; 73 received adjustable-loop (TightRope RT (Arthrex Inc., Naples, FL)) and 115 received fixed-loop (RetroButton (Arthrex Inc., Naples, FL)) femoral cortical suspension. The two groups were compared at six months, one year, and two years postoperatively using KT-1000 arthrometer testing and graft failure rate (revision surgery, grade 2+ Lachman test, any pivot shift, >5mm side-to-side KT-1000 difference).
Results:
There was no significant difference between the two groups in maximum side-to-side difference in KT-1000 testing at six months (mean 1.51mm (adjustable-loop group) vs. 1.79mm (fixed-loop group), p=0.23), one year (mean 1.44mm vs. 1.64mm, p=0.48), or two years (mean 1.14mm vs. 1.07mm, p=0.90) postoperatively. There was no significant difference between the two groups in rate of graft failure (10% vs. 11%, p=0.71) or timing of graft failure in affected patients (mean 11.4months vs. 13.8months, p=0.51).
Conclusions:
We found no significant difference in postoperative knee stability or graft failure rate between adjustable-loop and fixed-loop femoral cortical suspension in patients undergoing primary ACL reconstruction. Our results suggest that adjustable-loop suspension does not clinically loosen after ACL reconstruction.
Level Of Evidence:
III (retrospective cohort study).
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