Femoral Tunnel Widening Via Transcondylar Cross-Pin Fixation Versus Extracortical Suspensory Fixation After Single-Bundle ACLR: A Systematic Review and Meta-analysis
- Authors
- Celik, H.[Celik, H.]; Kim, J.-H.[Kim, J.-H.]; Lee, S.-H.[Lee, S.-H.]; Lee, D.-H.[Lee, D.-H.]
- Issue Date
- Apr-2021
- Publisher
- SAGE Publications Ltd
- Keywords
- anterior cruciate ligament; anterior cruciate ligament reconstruction; extracortical suspensory fixation; transcondylar cross fixation; tunnel widening
- Citation
- Orthopaedic Journal of Sports Medicine, v.9, no.4
- Indexed
- SCIE
SCOPUS
- Journal Title
- Orthopaedic Journal of Sports Medicine
- Volume
- 9
- Number
- 4
- URI
- https://scholarworks.bwise.kr/skku/handle/2021.sw.skku/24885
- DOI
- 10.1177/2325967121993811
- ISSN
- 2325-9671
- Abstract
- Background: Compared with extracortical suspensory fixation, the close-to-joint transcondylar cross-pin fixation method in anterior cruciate ligament reconstruction (ACLR) is believed to entail less intratunnel graft motion and subsequently lead to less tunnel widening. Purpose: To assess femoral tunnel widening via the transcondylar cross-pin method or the suspensory femoral fixation method in patients who had undergone ACLR. Study Design: Systematic review; Level of evidence, 4. Methods: This review focused on studies on femoral-tunnel widening after single-bundle ACLR with cross-pin (Rigidfix or Transfix) and/or Endobutton closed loop (CL). Two reviewers independently recorded data from each study, including the sample size and magnitude of tunnel widening after ACLR. Results: Overall, 19 studies were included in this meta-analysis. There was no significant difference between cross-pin and Endobutton CL fixations in the pooled absolute change in tunnel widening from the immediate postoperative period to the final follow-up; this was true at both the tunnel aperture (2.48 mm [95% CI, 1.76-3.2 mm] vs 2.93 mm [95% CI, 1.73-4.13 mm], respectively; P =.527) and the midpoint of the femoral tunnel (2.43 mm [95% CI, 1.77-3.1 mm] vs 2.54 mm [95% CI, –0.33 to 5.42 mm], respectively; P =.937). No significant difference was found in the relative percentage of femoral-tunnel widening between the 2 fixation methods (cross-pin, 43.3% [95% CI, 25.8%-60.8%] vs Endobutton CL, 42.0% [95% CI, 34.1%-49.9%]; P =.965). Conclusion: No significant difference in femoral tunnel widening was found to be associated with the use of either cross-pin or extracortical suspensory fixation in patients who underwent single-bundle ACLR. © The Author(s) 2021.
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