Supplementary tibial fixation in anterior cruciate ligament reconstruction - Direct cortical fixation using spiked washer screw vs. post-tie using washer screw

Abstract

We compare clinical outcomes of two different supplementary tibial fixation in anterior cruciate ligament (ACL) reconstruction using free tendon Achilles allograft. Eighty subjects underwent ACL reconstruction using Endobutton CL for femoral fixation and Bio-interference screw for tibial fixation. Supplementary tibial fixation was performed as direct cortical fixation using spiked washer screw (group I) or as post-tie using washer screw (group II). Lachman test, pivot shift test, IKDC classification, Lysholm score, and side-to-side difference (SSD) were evaluated. Thirty six in group I and thirty five in group II could follow up for at least 2 years. At the last followup, 7 in group I and 1 in group II showed 2+ or 3+ in Lachman test (p = 0.027). Mean SSD was 2.4mm in group I and 1 Amm in group II (p = 0.048). Post-tie using washer screw was more effective than direct cortical fixation using spiked washer screw to restore stability. Level of evidence : Therapeutic Level I; Randomized controlled clinical trial.