TY - JOUR
T1 - Fixation techniques for the anterior cruciate ligament reconstruction: early follow-up. A systematic review of level I and II therapeutic
AU - Cerulli, Giuliano Giorgio
PY - 2014
Y1 - 2014
N2 - The purpose of our study was that to systematically
review the fixation techniques for the ACL
reconstruction and associated clinical outcomes at the early
follow-up. Systematic search on three electronic databases
(Cochrane register, Medline and Embase) of fixation
devices used for primary ACL reconstruction with doubled
semitendinosus and gracilis and bone–patellar tendon–bone
autografts in randomized clinical trials of level I and II of
evidence published from January 2001 to December 2011.
Therapeutic studies collected were with a minimum 12-
month follow-up, and the clinical outcomes were evaluated
by at least one of International Knee Documentation
Committee, Lysholm and Tegner functional scales and at
least one of the following knee stability tests: arthrometric
AP tibial translation, Lachman test and pivot-shift test.
Nineteen articles met the inclusion criteria. At the femoral
side cross-pin, metallic interference screw, bioabsorbable
interference screw, and suspensory device were used in
32.3, 27.3, 24.8, 15.5 % of patients, respectively. At the
tibial side fixation was achieved with metallic interference
screw, bioabsorbable interference screw, screw and plastic
sheath, screw post and cross-pin in 38.7, 31, 15.7, 12.8, and
1.7 % of patients, respectively. Side-to-side anterior–
posterior tibial translation was 1.9 ± 0.9, 1.5 ± 0.9,
1.5 ± 0.8, 2.2 ± 0.4 mm for metallic interference screw,
bioabsorbable screw, cross-pin and suspensory device,
respectively. At least two-third of all the patients achieved
good-to-excellent clinical outcomes. Rate of failure was
6.1, 3.3, 1.7 and 1.2 % for bioabsorbable interference
screw, metallic interference screw, cross-pin and suspensory
device, respectively. Clinical outcomes are good to
excellent in almost two-third of the patients but several
pitfalls that affect the current fixation techniques as graft
tensioning such as graft-tunnel motion are still
unaddressed.
AB - The purpose of our study was that to systematically
review the fixation techniques for the ACL
reconstruction and associated clinical outcomes at the early
follow-up. Systematic search on three electronic databases
(Cochrane register, Medline and Embase) of fixation
devices used for primary ACL reconstruction with doubled
semitendinosus and gracilis and bone–patellar tendon–bone
autografts in randomized clinical trials of level I and II of
evidence published from January 2001 to December 2011.
Therapeutic studies collected were with a minimum 12-
month follow-up, and the clinical outcomes were evaluated
by at least one of International Knee Documentation
Committee, Lysholm and Tegner functional scales and at
least one of the following knee stability tests: arthrometric
AP tibial translation, Lachman test and pivot-shift test.
Nineteen articles met the inclusion criteria. At the femoral
side cross-pin, metallic interference screw, bioabsorbable
interference screw, and suspensory device were used in
32.3, 27.3, 24.8, 15.5 % of patients, respectively. At the
tibial side fixation was achieved with metallic interference
screw, bioabsorbable interference screw, screw and plastic
sheath, screw post and cross-pin in 38.7, 31, 15.7, 12.8, and
1.7 % of patients, respectively. Side-to-side anterior–
posterior tibial translation was 1.9 ± 0.9, 1.5 ± 0.9,
1.5 ± 0.8, 2.2 ± 0.4 mm for metallic interference screw,
bioabsorbable screw, cross-pin and suspensory device,
respectively. At least two-third of all the patients achieved
good-to-excellent clinical outcomes. Rate of failure was
6.1, 3.3, 1.7 and 1.2 % for bioabsorbable interference
screw, metallic interference screw, cross-pin and suspensory
device, respectively. Clinical outcomes are good to
excellent in almost two-third of the patients but several
pitfalls that affect the current fixation techniques as graft
tensioning such as graft-tunnel motion are still
unaddressed.
KW - ACL reconstruction
KW - Bone-patellar tendon-bone
KW - Doubled semitendinous and gracilis
KW - Fixation devices
KW - ACL reconstruction
KW - Bone-patellar tendon-bone
KW - Doubled semitendinous and gracilis
KW - Fixation devices
UR - http://hdl.handle.net/10807/60736
U2 - 10.1007/s12306-014-0338-8
DO - 10.1007/s12306-014-0338-8
M3 - Article
SN - 2035-5106
VL - 98
SP - 179
EP - 187
JO - Musculoskeletal Surgery
JF - Musculoskeletal Surgery
ER -