Published in:
01-08-2015 | Knee
A randomized prospective controlled study with 5-year follow-up of cross-pin femoral fixation versus metal interference screw fixation in anterior cruciate ligament reconstruction
Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 8/2015
Login to get accessAbstract
Purpose
The purpose of this study was to determine and compare mid- to long-term results of cross-pin versus metal interference screw fixation of ACL graft.
Methods
In a prospective trial, 62 patients were randomized into two groups based on method of fixation. Transtibial drilling technique was used in the cross-pin and outside-in femoral drilling in the interference screw fixation group. Clinical and radiographical outcomes were assessed 2 and 5 years postoperatively.
Results
The study showed no clinically significant difference with respect to method of graft fixation. Mean anteroposterior side-to-side instrumented laxity difference was 2.4 mm in the cross-pin group and 2.5 mm in the screw group (n.s.). Median Tegner and mean Lysholm scores at 5 years were 6 (range 3–9) and 92.2 (range 69–100) in the screw group and 7 (3–10) and 93.3 (82–100), respectively, in the cross-pin group. Radiographical osteoarthritis increased in both groups from 2 to 5 years after reconstruction (p < 0.05), especially in the medial and patellofemoral joint spaces. Widening of the drill tunnels continued from 2 to 5 years without clinical significance.
Conclusions and clinical relevance
The method of graft fixation did not yield a difference in clinical or radiographical outcome at 5 years. Results were excellent in both groups.
Level of evidence
I.