Published in:
01-08-2010 | Arthroscopy and Sports Medicine
Hybrid hamstring graft tibial fixation in anterior cruciate ligament reconstruction
Authors:
Miroslav Z. Milankov, Natasa Miljkovic, Natasa Janjic
Published in:
Archives of Orthopaedic and Trauma Surgery
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Issue 8/2010
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Abstract
Tibial fixation of the anterior cruciate ligament hamstring tendon graft is commonly considered more problematic than femoral fixation. When interference screws are used for tibial hamstring tendon graft fixation, graft sometimes looses its tension, so a hybrid fixation (more than one method of fixation) must be applied. Biomechanical studies show that an implementation of interference screws combined with different indirect distal hamstring tendon fixation techniques can withstand much higher tearing forces when compared with one type of fixation. We made a technique of hybrid tibial fixation of the hamstring graft using round interference screws and an additional bi-cortical 4.5-mm diameter screw with a modified head that allows control over the initial tension of the graft.