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Intratunnel femoral fixation of double-bundle ACL graft provides better instrumented knee laxity
Compared with extratunnel femoral fixation with cortical buttons, intratunnel femoral fixation of the double-bundle ACL graft from the cross-pin fixation technique provided better instrumented knee laxity, according to study results.
Researchers randomly assigned 70 patients with a unilateral ACL-deficient knee to fixation with two bioabsorbable Rigidfix pins (DePuy Synthes), one cross-pin per bundle (group A), or to be secured with one EndoButton cortical button (Smith & Nephew) per bundle. The researchers created all femoral tunnels through an anteromedial portal, and both groups received a bioabsorbable Biointrafix interface screw (DePuy Synthes) for tibial fixation. All patients were evaluated using history details, clinical examination findings, measurements of the joint laxity by KT-1000 arthrometer (Medmetric) and the responses from validated patient outcome questionnaires.
Overall, 34 patients in group A and 32 patients in group B were available for evaluation at a mean follow-up of 30 months. Regarding subjective and objective outcomes, results showed no statistically significant differences between the treatment groups, except for KT-1000 arthrometer values, according to the researchers.
The researchers observed a median KT-1000 value of 1.30 mm among patients in the cross-pin fixation group vs. 1.95 mm among patients in the cortical button fixation group. Instrumented knee laxity testing showed four patients in the cortical button group demonstrated failure of stability, whereas no patients in the cross-pin fixation group experienced failures. – by Casey Tingle
Disclosure: The researchers report no relevant financial disclosures.