Correlation between Position of Interference Screw in Tibial Tunnel and Graft Anatomical Orientation to Functional...

Anterior cruciate ligament (ACL) injuries are common among active individuals and often require surgical reconstruction. The position of the interference screw during tibial tunnel fixation may influence graft orientation and postoperative outcomes.

To evaluate the correlation between interference screw position in the tibial tunnel, graft inclination, and functional outcomes following single-bundle ACL reconstruction.

This prospective observational study included 47 patients aged 16-66 years with isolated ACL tears. All patients underwent single-bundle ACL reconstruction using a standardized technique. Interference screws were placed either anterior or posterior to the graft within the tibial tunnel. Graft inclination was measured via postoperative magnetic resonance imaging. Functional outcomes were assessed using Lysholm and IKDC scores pre- and postoperatively. Statistical analyses included t -tests, Pearson's correlation, and Chi-square tests.

Posterior screw placement was significantly associated with better functional outcomes (Lysholm: P <0.001; IKDC: P <0.001). The inclination angle of the graft negatively correlated with both Lysholm ( r = -0.381, P = 0.008) and IKDC ( r = -0.366, P = 0.011) scores, indicating that steeper graft angles were linked to poorer outcomes. No significant correlation was found between screw angle and postoperative scores.

Posterior placement of the interference screw improves graft alignment and functional outcomes after ACL reconstruction. Accurate screw and graft positioning are vital for optimal surgical success.