Purpose
To compare the clinical outcomes of femoral knot/press-fit anterior cruciate ligament
(ACL) reconstruction with conventional techniques using femoral interference screws.
Methods
Among patients who underwent arthroscopic ACL reconstruction with hamstring autografts,
73 were treated with either a femoral knot/press-fit technique (40 patients, group
A) or femoral interference screw fixation (33 patients, group B). The clinical results
of the 2 groups were retrospectively compared. The inclusion criteria were primary
ACL reconstruction in active patients. The exclusion criteria were fractures, multiligamentous
injuries, patients undergoing revision, or patients with contralateral ACL-deficient
knees. In the femoral knot/press-fit technique, semitendinosus and gracilis tendons
were prepared as 2 loops with knots. After passage through a bottleneck femoral tunnel,
the grafts were fixed with a press-fit method (grafts' knots were stuck in the bottleneck
of the femoral tunnel). A tie with Mersilene tape (Ethicon, Somerville, NJ) over a
bone bridge for each tendon loop and an additional bioabsorbable interference screw
were used for tibial fixation.
Results
The mean follow-up period was 38 months (range, 24 to 61 months). A significant improvement
in knee function and symptoms was reported in most patients, as shown by improved
Tegner scores, Lysholm knee scores, and International Knee Documentation Committee
assessments (
P < .01). The results of instrumented laxity testing, thigh muscle assessment, and
radiologic assessment were clearly improved when compared with the preoperative status
(
P < .01). No statistically significant difference in outcomes could be observed between
group A and group B (
P = not significant).
Conclusions
In this nonrandomized study, femoral knot/press-fit ACL reconstruction did not appear
to provide increased anterior instability compared with that of conventional femoral
interference screw ACL reconstruction. Favorable outcomes with regard to knee stability
and patient satisfaction were achieved in most of our ACL-reconstructed patients using
femoral knot/press-fit fixation with hamstring tendon autograft.
Level of Evidence
Level IV, therapeutic case series.
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Article Info
Publication History
Published online: April 24, 2014
Accepted:
February 27,
2014
Received:
September 4,
2013
Footnotes
The authors report that they have no conflicts of interest in the authorship and publication of this article.
Identification
Copyright
© 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
