Transcondylar screw fixation in anterior cruciate ligament reconstruction☆

Abstract 

Purpose: The purpose of this study was to investigate the outcomes of 2 different methods of femoral fixation for arthroscopically assisted anterior cruciate ligament (ACL) reconstruction. Type of Study: Double-blind prospective study. Methods: Fifty-five patients were prospectively evaluated at 2-year follow-up. In group A, 24 patients underwent arthroscopic ACL reconstruction with bone–patellar tendon–bone and interference screw fixation. In group B, 31 patients underwent arthroscopic ACL reconstruction with bone–patellar tendon–bone and transcondylar screw fixation. Patients were evaluated by using the IKDC form, Lysholm-II form, Tegner scoring system, and KT-2000 arthrometer. Results: In group A, final IKDC clinical evaluation achieved 0% grade A, 62.5% grade B, 25% grade C, and 12.5% grade D. In group B, 29.1% achieved grade A, 54.8% grade B, 12.9% grade C, and 3.2% grade D. The difference was statistically significant (P < .05). The injured versus normal side-to-side KT-2000 difference at maximum manual loading was 3.68 mm (SD, 1.71) in group A and 1.64 (SD, 2.05) in group B (P < .0001). Conclusions: This prospective study could not provide significant data suggesting that 1 method of fixation is superior to the other. Therefore, we consider both methods comparable in terms of stability and functional outcome at short-term follow-up. Transcondylar fixation offers the following advantages: fixation without intra-articular hardware, greater bone-to-bone fixation, and the possibility of fixation with breakage of the posterior femoral tunnel wall. Moreover, this method may be a useful alternative in revision ACL surgery.

Arthroscopy: The Journal of Arthroscopic and Related Surgery, Vol 17, No 7 (September), 2001: pp 717–723

Keywords:  ACL reconstruction, Fixation, Knee, Arthroscopy