Clinical and radiographic results after ACL reconstruction using an adjustable-loop device

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Sports Medicine

Background:

• Anterior cruciate ligament reconstruction (ACLR) commonly utilizes femoral cortical suspension devices.
• Adjustable-loop devices (ALDs) are increasingly used in ACLR, but clinical and radiographic data are limited.
• The ToggleLoc with zip loop is an ALD for ACLR, with few prior studies on its outcomes.

Purpose of the Study:

• To evaluate the clinical and radiographic results of ACLR using the ToggleLoc ALD.
• To assess knee stability and bone tunnel enlargement after ACLR with this device.
• To compare outcomes between single bundle reconstruction (SBR) and double bundle reconstruction (DBR) groups.

Main Methods:

• 80 patients undergoing ACLR with ToggleLoc ALD were followed for ≥2 years.
• Patients were divided into SBR and DBR groups.
• Clinical outcomes (subjective and objective scores) and radiographic assessments (femoral and tibial tunnel enlargement via 3D CT) were performed.

Main Results:

• Significant improvements in postoperative subjective and objective clinical scores were observed in both SBR and DBR groups.
• Femoral tunnel enlargement in SBR was 104.3% ± 21.2% and tibial was 89.2% ± 15.2% at 2 years.
• DBR showed femoral tunnel volume changes of 107.0% ± 3.5% (AM) and 108.1% ± 3.3% (PL), and tibial changes of 90.6% ± 3.3% (AM) and 87.0% ± 4.2% (PL).
• Femoral tunnel enlargement peaked at 12 months and decreased by 24 months; tibial tunnel enlargement consistently decreased over 2 years.

Conclusions:

• ACLR using ToggleLoc ALDs yields favorable clinical outcomes.
• The ToggleLoc ALD provides good knee stability.
• Relatively minimal bone tunnel enlargement was observed in both SBR and DBR groups.