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Outcomes of ACL Reconstruction With Fixed Versus Variable Loop Button Fixation.

Brent T Wise, Nick N Patel, Garrison Wier

    Orthopedics
    |November 23, 2016
    PubMed
    Summary
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    This study found no significant difference in anterior cruciate ligament (ACL) graft laxity or patient outcomes between fixed loop and variable loop button fixation methods in ACL reconstruction surgery.

    Area of Science:

    • Orthopedic Surgery
    • Sports Medicine
    • Biomedical Engineering

    Background:

    • Anterior cruciate ligament (ACL) reconstruction is a common orthopedic procedure.
    • Femoral fixation of ACL grafts using button devices is a popular technique.
    • Fixed loop and variable loop button devices are two common methods for graft fixation.

    Purpose of the Study:

    • To compare the efficacy of fixed loop versus variable loop button devices for ACL graft fixation.
    • To evaluate the impact of these fixation methods on graft laxity and patient-reported outcomes.

    Main Methods:

    • A retrospective database search identified patients undergoing ACL reconstruction with either fixation technique.
    • KT-1000 arthrometer testing was used to measure knee laxity, comparing operated and uninjured knees.

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  • Patient-reported outcome scores (Lysholm, Tegner, SF-12) were collected and analyzed.

    • Main Results:

    • No statistically significant difference in average KT-1000 laxity values between the variable (0.38 mm) and fixed (0.92 mm) loop groups (P=.19).
    • Similar subjective outcome scores and clinically lax knees (KT-1000>3 mm) rates between the two groups.
    • Rerupture rates were comparable: 4.7% for variable loop and 8.7% for fixed loop (P=.21).

    Conclusions:

    • Both variable loop and fixed loop button devices provide comparable ACL graft laxity.
    • Patient-reported functional outcomes are similar regardless of the button fixation technique used.
    • The study suggests no significant advantage of one fixation method over the other in this cohort.