Skip to main content
Erschienen in: Archives of Orthopaedic and Trauma Surgery 2/2016

01.02.2016 | Arthroscopy and Sports Medicine

Comparison of different femoral fixation implants and fit techniques for tunnel widening and clinical outcome in ACL reconstruction using hamstring autograft

verfasst von: B. Saygi, O. Karaman, E. Sirin, I. Arslan, A. I. Demir, A. Oztermeli

Erschienen in: Archives of Orthopaedic and Trauma Surgery | Ausgabe 2/2016

Einloggen, um Zugang zu erhalten

Abstract

Purpose

The purpose of the current study is to investigate in different femoral fixation devices whether tight (undersize drilled) fit technique decreases the tunnel widening and improves the clinical outcome compared to conventional technique in ACL reconstruction using hamstring tendon autograft.

Methods

93 patients, who underwent Arthroscopic ACL reconstruction whether cortical-cancellous suspension (CP) or cortical suspension (BF) used as fixation device for the hamstring tendon autograft, were included in the study. The cases also grouped as undersize drilled (tight fit) and normal drilled (normal fit) according to their autograft size. There was no difference in demographic data of these four subgroups (CP-TF, CP-NF, BF-TF, and BF-NF) preoperatively.

Results

The patients, who had been followed for at least 2 years were included in the study. They were looked for their clinical outcome (Lysholm and IKDC scoring), tunnel widening (on AP and lateral radiographs), and also anterior translation. The BF-TF subgroup showed significantly the best clinical results compared to other three subgroups. There was no difference between BF-TF, CP-TF, and CP-NF in terms of tunnel widening.

Conclusion

Button fixation of femoral side in ACL reconstruction surgery has good clinical outcome and lower complication rate. Undersize drilling might be preferred in button fixation in order to reduce TW and improve stability and clinical satisfaction.

Level of evidence

Therapeutic case series, Level IV.
Literatur
1.
Zurück zum Zitat Kong CG, In Y, Kim GH, Ahn CY (2012) Cross pins versus endobutton femoral fixation in hamstring anterior cruciate ligament reconstruction: minimum 4-year follow-up. Knee Surg Relat Res 24(1):34–39PubMedCentralCrossRefPubMed Kong CG, In Y, Kim GH, Ahn CY (2012) Cross pins versus endobutton femoral fixation in hamstring anterior cruciate ligament reconstruction: minimum 4-year follow-up. Knee Surg Relat Res 24(1):34–39PubMedCentralCrossRefPubMed
2.
Zurück zum Zitat Hamner DL, Brown CH Jr, Steiner ME, Hecker AT, Hayes WC (1999) Hamstring tendon grafts for reconstruction of the anterior cruciate ligament: biomechanical evaluation of the use of multiple strands and tensioning techniques. J Bone Joint Surg Am 81(4):549–557PubMed Hamner DL, Brown CH Jr, Steiner ME, Hecker AT, Hayes WC (1999) Hamstring tendon grafts for reconstruction of the anterior cruciate ligament: biomechanical evaluation of the use of multiple strands and tensioning techniques. J Bone Joint Surg Am 81(4):549–557PubMed
3.
Zurück zum Zitat To JT, Howell SM, Hull ML (1999) Contributions of femoral fixation methods to the stiffness of anterior cruciate ligament replacements at implantation. Arthroscopy 15(4):379–387CrossRefPubMed To JT, Howell SM, Hull ML (1999) Contributions of femoral fixation methods to the stiffness of anterior cruciate ligament replacements at implantation. Arthroscopy 15(4):379–387CrossRefPubMed
4.
Zurück zum Zitat Hwang DH, Shetty GM, Kim JI, Kwon JH, Song JK, Muñoz M, Lee JS, Nha KW (2013) Does press-fit technique reduce tunnel volume enlargement after anterior cruciate ligament reconstruction with autologous hamstring tendons? A prospective randomized computed tomography study. Arthroscopy 29(1):83–88CrossRefPubMed Hwang DH, Shetty GM, Kim JI, Kwon JH, Song JK, Muñoz M, Lee JS, Nha KW (2013) Does press-fit technique reduce tunnel volume enlargement after anterior cruciate ligament reconstruction with autologous hamstring tendons? A prospective randomized computed tomography study. Arthroscopy 29(1):83–88CrossRefPubMed
5.
Zurück zum Zitat Siebold R, Kiss ZS, Morris HG (2008) Effect of compaction drilling during ACL reconstruction with hamstrings on postoperative tunnel widening. Arch Orthop Trauma Surg 128(5):461–468CrossRefPubMed Siebold R, Kiss ZS, Morris HG (2008) Effect of compaction drilling during ACL reconstruction with hamstrings on postoperative tunnel widening. Arch Orthop Trauma Surg 128(5):461–468CrossRefPubMed
6.
Zurück zum Zitat Nebelung S, Deitmer G, Gebing R, Reichwein F, Nebelung W (2012) High incidence of tunnel widening after anterior cruciate ligament reconstruction with transtibial femoral tunnel placement. Arch Orthop Trauma Surg 132(11):1653–1663CrossRefPubMed Nebelung S, Deitmer G, Gebing R, Reichwein F, Nebelung W (2012) High incidence of tunnel widening after anterior cruciate ligament reconstruction with transtibial femoral tunnel placement. Arch Orthop Trauma Surg 132(11):1653–1663CrossRefPubMed
7.
Zurück zum Zitat Firat A, Catma F, Tunc B, Hacihafizoglu C, Altay M, Bozkurt M, Kapicioglu MI (2014) The attic of the femoral tunnel in anterior cruciate ligament reconstruction: a comparison of outcomes of two suspensory femoral fixation systems. Knee Surg Sports Traumatol Arthrosc 22(5):1097–1105CrossRefPubMed Firat A, Catma F, Tunc B, Hacihafizoglu C, Altay M, Bozkurt M, Kapicioglu MI (2014) The attic of the femoral tunnel in anterior cruciate ligament reconstruction: a comparison of outcomes of two suspensory femoral fixation systems. Knee Surg Sports Traumatol Arthrosc 22(5):1097–1105CrossRefPubMed
8.
Zurück zum Zitat Zantop T, Petersen W (2008) Double bundle revision of a malplaced single bundle vertical ACL reconstruction: ACL revision surgery using a two femoral tunnel technique. Arch Orthop Trauma Surg 128(11):1287–1294CrossRefPubMed Zantop T, Petersen W (2008) Double bundle revision of a malplaced single bundle vertical ACL reconstruction: ACL revision surgery using a two femoral tunnel technique. Arch Orthop Trauma Surg 128(11):1287–1294CrossRefPubMed
9.
Zurück zum Zitat Fauno P, Kaalund S (2005) Tunnel widening after hamstring anterior cruciate ligament reconstruction is influenced by the type of graft fixation used: a prospective randomized study. Arthroscopy 21(11):1337–1341CrossRefPubMed Fauno P, Kaalund S (2005) Tunnel widening after hamstring anterior cruciate ligament reconstruction is influenced by the type of graft fixation used: a prospective randomized study. Arthroscopy 21(11):1337–1341CrossRefPubMed
10.
Zurück zum Zitat Hoher J, Möller HD, Fu FH (1998) Bone tunnel enlargement after anterior cruciate ligament reconstruction: fact or fiction? Knee Surg Sports Traumatol Arthrosc 6(4):231–240CrossRefPubMed Hoher J, Möller HD, Fu FH (1998) Bone tunnel enlargement after anterior cruciate ligament reconstruction: fact or fiction? Knee Surg Sports Traumatol Arthrosc 6(4):231–240CrossRefPubMed
11.
Zurück zum Zitat Buck DC, Simonian PT, Larson RV, Borrow J, Nathanson DA (2004) Timeline of tibial tunnel expansion after single-incision hamstring anterior cruciate ligament reconstruction. Arthroscopy 20(1):34–36CrossRefPubMed Buck DC, Simonian PT, Larson RV, Borrow J, Nathanson DA (2004) Timeline of tibial tunnel expansion after single-incision hamstring anterior cruciate ligament reconstruction. Arthroscopy 20(1):34–36CrossRefPubMed
12.
Zurück zum Zitat Price R, Stoney J, Brown G (2010) Prospective randomized comparison of endobutton versus cross-pin femoral fixation in hamstring anterior cruciate ligament reconstruction with 2-year follow-up. ANZ J Surg 80(3):162–165CrossRefPubMed Price R, Stoney J, Brown G (2010) Prospective randomized comparison of endobutton versus cross-pin femoral fixation in hamstring anterior cruciate ligament reconstruction with 2-year follow-up. ANZ J Surg 80(3):162–165CrossRefPubMed
13.
Zurück zum Zitat Clark R, Olsen RE, Larson BJ, Goble EM, Farrer RP (1998) Cross-pin femoral fixation: a new technique for hamstring anterior cruciate ligament reconstruction of the knee. Arthroscopy 14(3):258–267CrossRefPubMed Clark R, Olsen RE, Larson BJ, Goble EM, Farrer RP (1998) Cross-pin femoral fixation: a new technique for hamstring anterior cruciate ligament reconstruction of the knee. Arthroscopy 14(3):258–267CrossRefPubMed
14.
Zurück zum Zitat Wolf EM (1998) Semitendinosus and gracilis anterior cruciate ligament reconstruction using the transfix technique. Tech Ortop 13:329–336CrossRef Wolf EM (1998) Semitendinosus and gracilis anterior cruciate ligament reconstruction using the transfix technique. Tech Ortop 13:329–336CrossRef
15.
Zurück zum Zitat Zhai W, Lv C, Zheng Y, Gao Y, Ding Z, Chen Z (2013) Weak link of tendon–bone healing and a control experiment to promote healing. Arch Orthop Trauma Surg 133(11):1533–1541CrossRefPubMed Zhai W, Lv C, Zheng Y, Gao Y, Ding Z, Chen Z (2013) Weak link of tendon–bone healing and a control experiment to promote healing. Arch Orthop Trauma Surg 133(11):1533–1541CrossRefPubMed
16.
Zurück zum Zitat Choi NH, Oh JS, Jung SH, Victoroff BN (2013) Correlation between endobutton loop length and tunnel widening after hamstring anterior cruciate ligament reconstruction. Am J Sports Med 41(1):101–106CrossRefPubMed Choi NH, Oh JS, Jung SH, Victoroff BN (2013) Correlation between endobutton loop length and tunnel widening after hamstring anterior cruciate ligament reconstruction. Am J Sports Med 41(1):101–106CrossRefPubMed
17.
Zurück zum Zitat Buelow JU, Siebold R, Ellermann A (2002) A prospective evaluation of tunnel enlargement in anterior cruciate ligament reconstruction with hamstrings: extracortical versus anatomical fixation. Knee Surg Sports Traumatol Arthrosc 10(2):80–85CrossRefPubMed Buelow JU, Siebold R, Ellermann A (2002) A prospective evaluation of tunnel enlargement in anterior cruciate ligament reconstruction with hamstrings: extracortical versus anatomical fixation. Knee Surg Sports Traumatol Arthrosc 10(2):80–85CrossRefPubMed
18.
Zurück zum Zitat Majewski M, Susanne H, Klaus S (2006) Epidemiology of athletic knee injuries: a 10-year study. Knee. 13(3):184–188CrossRefPubMed Majewski M, Susanne H, Klaus S (2006) Epidemiology of athletic knee injuries: a 10-year study. Knee. 13(3):184–188CrossRefPubMed
19.
Zurück zum Zitat Baumfeld JA, Diduch DR, Rubino LJ, Hart JA, Miller MD, Barr MS, Hart JM (2008) Tunnel widening following anterior cruciate ligament reconstruction using hamstring autograft: a comparison between double cross-pin and suspensory graft fixation. Knee Surg Sports Traumatol Arthrosc 16(12):1108–1113CrossRefPubMed Baumfeld JA, Diduch DR, Rubino LJ, Hart JA, Miller MD, Barr MS, Hart JM (2008) Tunnel widening following anterior cruciate ligament reconstruction using hamstring autograft: a comparison between double cross-pin and suspensory graft fixation. Knee Surg Sports Traumatol Arthrosc 16(12):1108–1113CrossRefPubMed
20.
Zurück zum Zitat Sabat D, Kundu K, Arora S, Kumar V (2011) Tunnel widening after anterior cruciate ligament reconstruction: a prospective randomized computed tomography-based study comparing 2 different femoral fixation methods for hamstring graft. Arthroscopy 27(6):776–783CrossRefPubMed Sabat D, Kundu K, Arora S, Kumar V (2011) Tunnel widening after anterior cruciate ligament reconstruction: a prospective randomized computed tomography-based study comparing 2 different femoral fixation methods for hamstring graft. Arthroscopy 27(6):776–783CrossRefPubMed
21.
Zurück zum Zitat Jansson KA, Harilainen A, Sandelin J, Karjalainen PT, Aronen HJ, Tallroth K (1999) Bone tunnel enlargement after anterior cruciate ligament reconstruction with the hamstring autograft and endobutton fixation technique. A clinical, radiographic and magnetic resonance imaging study with 2 years follow-up. Knee Surg Sports Traumatol Arthrosc 7(5):290–295CrossRefPubMed Jansson KA, Harilainen A, Sandelin J, Karjalainen PT, Aronen HJ, Tallroth K (1999) Bone tunnel enlargement after anterior cruciate ligament reconstruction with the hamstring autograft and endobutton fixation technique. A clinical, radiographic and magnetic resonance imaging study with 2 years follow-up. Knee Surg Sports Traumatol Arthrosc 7(5):290–295CrossRefPubMed
22.
Zurück zum Zitat Webster KE, Feller JA, Elliott J, Hutchison A, Payne R (2004) A comparison of bone tunnel measurements made using computed tomography and digital plain radiography after anterior cruciate ligament reconstruction. Arthroscopy 20(9):946–950CrossRefPubMed Webster KE, Feller JA, Elliott J, Hutchison A, Payne R (2004) A comparison of bone tunnel measurements made using computed tomography and digital plain radiography after anterior cruciate ligament reconstruction. Arthroscopy 20(9):946–950CrossRefPubMed
23.
Zurück zum Zitat Ganko A, Engebretsen L, Ozer H (2000) The rolimeter: a new arthrometer compared with the KT-1000. Knee Surg Sports Traumatol Arthrosc 8(1):36–39CrossRefPubMed Ganko A, Engebretsen L, Ozer H (2000) The rolimeter: a new arthrometer compared with the KT-1000. Knee Surg Sports Traumatol Arthrosc 8(1):36–39CrossRefPubMed
24.
Zurück zum Zitat Schuster AJ, McNicholas MJ, Wachtl SW, McGurty DW, Jakob RP (2004) A new mechanical testing device for measuring anteroposterior knee laxity. Am J Sports Med 32(7):1731–1735CrossRefPubMed Schuster AJ, McNicholas MJ, Wachtl SW, McGurty DW, Jakob RP (2004) A new mechanical testing device for measuring anteroposterior knee laxity. Am J Sports Med 32(7):1731–1735CrossRefPubMed
25.
Zurück zum Zitat Ballal MS, Khan Y, Hastie G, Hatcher A, Coogan S, McNicholas MJ (2013) Functional outcome of primary hamstring anterior cruciate ligament reconstruction in patients with different body mass index classes. Arthroscopy 29(8):1314–1321CrossRefPubMed Ballal MS, Khan Y, Hastie G, Hatcher A, Coogan S, McNicholas MJ (2013) Functional outcome of primary hamstring anterior cruciate ligament reconstruction in patients with different body mass index classes. Arthroscopy 29(8):1314–1321CrossRefPubMed
26.
Zurück zum Zitat Sinha S, Naik AK, Meena D, Jain VK, Arya RK (2014) Creation of femoral tunnel by outside-in technique for ACL reconstruction: an analysis. Arch Orthop Trauma Surg 134(12):1709–1716CrossRefPubMed Sinha S, Naik AK, Meena D, Jain VK, Arya RK (2014) Creation of femoral tunnel by outside-in technique for ACL reconstruction: an analysis. Arch Orthop Trauma Surg 134(12):1709–1716CrossRefPubMed
Metadaten
Titel
Comparison of different femoral fixation implants and fit techniques for tunnel widening and clinical outcome in ACL reconstruction using hamstring autograft
verfasst von
B. Saygi
O. Karaman
E. Sirin
I. Arslan
A. I. Demir
A. Oztermeli
Publikationsdatum
01.02.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Archives of Orthopaedic and Trauma Surgery / Ausgabe 2/2016
Print ISSN: 0936-8051
Elektronische ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-015-2348-x

Weitere Artikel der Ausgabe 2/2016

Archives of Orthopaedic and Trauma Surgery 2/2016 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Ärztliche Empathie hilft gegen Rückenschmerzen

23.04.2024 Leitsymptom Rückenschmerzen Nachrichten

Personen mit chronischen Rückenschmerzen, die von einfühlsamen Ärzten und Ärztinnen betreut werden, berichten über weniger Beschwerden und eine bessere Lebensqualität.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.