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More revision seen with hamstring tendon autograft fixation combinations using biodegradable screws
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LYON, France — Using data from the Norwegian Knee Ligament Registry to compare 2-year revision rates of the most common femoral/tibial fixation combinations for hamstring tendon autograft used during primary ACL reconstruction, researchers found significantly higher odds for revision when biodegradable screws were used compared with the various fixation combinations for patella tendon autograft.
“Fixation has an impact on the risk of revision. How you fix the graft is important. What sort of combination you use is very important, and we found that combinations with Endobutton (Smith & Nephew) have a higher risk of revision, especially with Endobutton when paired with BioSureHA (Smith & Nephew),” Knut Fjeldsgaard, MD, of the Department of Orthopedic Surgery at Haukeland University Hospital, Bergen, Norway, said during his presentation at the International Society for Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS) Biennial Congress, here. He also called for multiple-registry cooperation to further investigate these early findings.
Fjeldsgaard and colleagues used the registry to identify femoral/tibial combinations used in more than 500 patients. The study included 10,228 patients who underwent reconstruction using hamstring tendon autografts. The most popular combination was femoral extratunnel fixation (6,308 patients), with Endobutton / RCI screw (2,339 patients), Endobutton / BioSureHA (1,209 patients) and Endobutton / Intrafix (687 patients) combinations being used the most. There were 3,668 cases in which femoral intratunnel fixation with the EzLoc / WasherLoc combination was used, with the TransFix II / metal interference screw (Arthrex) combination being the most commonly used.
Compared with a group of 3,806 patients who had patella tendon autograft and a 0.7% revision rate at 2 years, the researchers found significantly higher revision rates with all five hamstring autograft combinations (range: 5.5% to 1.5%). The highest revision rates were found for Endobutton / BioSureHA (5.5%), Endobutton / Intrafix (3.8%) and Endobutton / RCI (3.5%).
After adjusting for confounding variables, the researchers found a similar trend with the Endobutton / BioSureHA combination, showing a 7.3-times higher hazard ratio compared with patella tendon graft. – by Gina Brockenbrough, MA
Reference:
Fjeldsgaard K, et al. Paper #194. Presented at: International Society for Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine Biennial Congress; June 7-11, 2015; Lyon, France.
Disclosure: Fjeldsgaard reports no relevant financial disclosures.