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Influence of three different fixation methods on femoral tunnel widening in ACL reconstructed patients evaluated
Ravindra Lamoria1, Arun Sharma1, Divyanshu Goyal2
1Department of Orthopaedics, SMS Medical College and Hospitals, JLN Marg, Jaipur, Rajasthan, India.
Purpose:
To evaluate femoral tunnel widening in young and active patients undergoing ACL reconstruction with quadrupled hamstring graft with fixation on tibial side performed with a Bioscrew while femoral fixation performed with either a Tight rope Reverse Threaded (RT) or Transfix or another Bioscrew using CT scan.
Material And Method:
A total of 100 consecutive patients underwent single-bundle ACL reconstruction from January 2008 to March 2012. Eighty-six out of these were available with us till the final follow-up. Only 20-40-year-old males with unilateral ACL rupture less than a year old, diagnosed clinically and confirmed radiologically by magnetic resonance imaging, were selected for the study. All patients were evaluated clinically as well as radiologically at follow-up of 2 weeks, 1 month, 3 months, 6 months, 1 year and every 6 months thereafter. CT scans were performed at 2 weeks, 6 months, and 1 year postoperatively. The data acquired at the second week were considered as baseline data and were used for comparison with the data acquired at 6 months and 1 year.
Results:
The dilatation at the aperture was significantly more in the Tight rope RT group as compared to the other two groups (p value 0.019 and 0.021 for sagittal and coronal images, respectively).
Conclusion:
There is no significant difference between the three different fixation modes in context of tunnel enlargement except with Tight rope RT device which leads to statistically significant dilatation at aperture. Future studies with longer follow-up are required to evaluate its clinical implications.
