Hybrid Tibial Fixation for Anterior Cruciate Ligament Reconstruction With Achilles Tendon Allograft
- Authors
- Noh, Jung Ho; Yang, Bo Gyu; Yi, Seung Rim; Roh, Young Hak; Lee, Jun Suk
- Issue Date
- Oct-2012
- Publisher
- W B SAUNDERS CO-ELSEVIER INC
- Citation
- ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY, v.28, no.10, pp.1540 - 1546
- Journal Title
- ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY
- Volume
- 28
- Number
- 10
- Start Page
- 1540
- End Page
- 1546
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/16125
- DOI
- 10.1016/j.arthro.2012.03.012
- ISSN
- 0749-8063
- Abstract
- Purpose: To compare clinical outcomes of tibial fixation between a biodegradable interference screw only and a biodegradable interference screw supplemented by a post-tie using a washer screw in single-bundle anterior cruciate ligament (ACL) reconstruction with 2-strand free tendon Achilles allograft in active young men. Methods: A prospective study was performed in 80 subjects who underwent single-bundle ACL reconstruction. A 2-strand free tendon Achilles allograft fixed with an EndoButton (Smith & Nephew, Andover, MA) in the femoral tunnel and with a Bio-Interference screw (Arthrex, Naples, FL) in the tibial tunnel was used in group I. Supplementary fixation was performed with a post-tie using a washer screw in group II. The Lachman test, pivot-shift test, International Knee Documentation Committee classification, Lysholm score, range of knee motion, and side-to-side difference were evaluated preoperatively and at the last follow-up. The Tegner activity scale was evaluated before injury and at the last follow-up. The 1-leg hop test was assessed at the last follow-up. Results: Of the patients, 36 in group I and 35 in group II could be followed up for at least 2 years. At the last follow-up, 7 patients in group I and 1 in group II showed a 2+ or 3+ on the Lachman test (P = .027). The mean side-to-side difference was 2.9 +/- 2.3 mm in group I and 1.4 +/- 1.6 mm in group II at the last follow-up (P = .002). The other clinical outcomes were not significantly different between the 2 groups. Conclusions: Supplementary tibial fixation with a post-tie in ACL reconstruction using 2-strand free tendon Achilles allograft was more effective than a biodegradable interference screw only in restoration of the anterior stability of the tibia. Level of Evidence: Level II, randomized controlled trial.
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