ABSTRACT
Background:Cortical suspension devices have been widely used in anterior cruciate ligament reconstruction (ACLR) for femoral side graft fixation. Fixed-length and adjustable-length loop devices are two common suspensory loop devices that are used in ACLR. They both have their own biomechanical pros and cons. The purpose of this study is to determine the difference in functional outcome of anatomical single-bundle ACLR using fixed-length versus adjustable-length loop in femoral fixation of quadrupled hamstring graft
Materials and Methods:It is a longitudinal prospective study conducted in various military hospitals of Indian army. There were 60 patients enrolled in the study. The first 30 patients were treated with arthroscopic ACLR with quadrupled hamstring graft from ipsilateral limb fixed with Endobutton on femoral side and bioabsorbable interference tibial screw; similarly, in subsequent 30 patients, ACLR with quadrupled hamstring graft from ipsilateral limb fixed with closed adjustable loop on femoral side and bioabsorbable interference tibial screw. Their clinical and functional status were assessed preoperatively on the day before surgery and the last follow-up at one following the surgery with Tegner Lysholm score and 2000 International Knee Documentation Committee (IKDC) scores.
Results:The average pre-operative Tegner Lysholm score before surgery in Endobutton group was 56.63 ± 6.7 and post-operative score at last follow-up was 93.97 ± 4.1, and for closed adjustable loop group, it was 56.5 ± 7.1 and 94.7 ± 3.7, respectively. The average 2000 IKDC score before surgery in Endobutton group was 46.16 ± 6.1 and post-operative score at the last follow-up was 82.52 ± 4.2, and for closed adjustable loop group, it was 46.57 ± 6.5 and 83.98 ± 4.1, respectively. Two sample Student’s t-test was conducted to compare the mean of post-operative Tegner Lysholm score and 2000 IKDC for each group it showed P value for Tegner Lysholm score to be 0.75 and that for 2000 IKDC score to be 0.7, which not statistically significant to reject the null hypothesis.
Conclusions: Cortical suspension devices for femoral tunnel graft fixation are very efficient devices whether fixed length or adjustable length. Fixed-length and adjustable-loop cortical suspension devices are equally effective in femoral fixation of graft in ACLR.
Keywords:Adjustable-length loop device, Anterior cruciate ligament, Cortical suspension device, Fixed-length loop device.