Patrick Björkman1, Jerker Sandelin2, Arsi Harilainen2. 1. Helsinki University Central Hospital, Helsinki, Finland. patrick.bjorkman@hus.fi. 2. ORTON Orthopaedic Hospital, Helsinki, Finland.
Abstract
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 meanLysholm 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.
RCT Entities:
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.
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