Anterior Cruciate Ligament Reconsruction using Tibialis Tendon Allograft - Comparison of the Results according to the Femoral Fixation Methods -

Sung-Do Cho; Chang-Youl Gwak; Chang-Yun Jung

doi:10.4055/jkoa.2007.42.3.373

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Cho, Gwak, and Jung: Anterior Cruciate Ligament Reconsruction using Tibialis Tendon Allograft - Comparison of the Results according to the Femoral Fixation Methods -

Original Article

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2007; 42(3): 373-379.

Published online: 30 June 2007

DOI: https://doi.org/10.4055/jkoa.2007.42.3.373

Anterior Cruciate Ligament Reconsruction using Tibialis Tendon Allograft - Comparison of the Results according to the Femoral Fixation Methods -

Sung-Do Cho, M.D., Chang-Youl Gwak, M.D., Chang-Yun Jung, M.D.

Department of Orthopedic Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.

Address reprint requests to Sung-Do Cho, M.D. Department of Orthopedic Surgery, Ulsan University Hospital, 290-3, Jeonha-dong, Dong-gu, Ulsan 682-714, Korea. Tel: +82.52-250-7129, Fax: +82.52-235-2823, sdcho@uuh.ulsan.kr

Abstract

Purpose

To compare the clinical stability and function of two femoral fixation methods after arthroscopic anterior cruciate ligament (ACL) reconstruction using fresh-frozen tibialis tendon allograft.

Materials and Methods

For femoral fixation, endopearl and bioabsorbable interference screw were used in 31 patients (group I) and RIGIDfix®, in 36 patients (group II). The mean follow-up period was 30 months. The evaluations included Lysholm knee score, 2000 International Knee Documentation Committee (IKDC) subjective knee score, Lachman test, pivot shift test, KT-1000 arthrometer measurement and 2000 IKDC knee examination.

Results

Twenty-eight patients (90.3%) in group I and 33 (91.7%) in group II were good or excellent according to the Lysholm score. Twenty-seven patients (87.1%) in group I and 33 (91.7%) in group II had IKDC subjective knee score >70. Thirty patients (96.8%) in group I and 35 (97.2)% in group II had 1+firm end or negative Lachman test. Twenty-seven patients (87.1%) in group I and 35 (97.2%) in group II had a negative pivot shift. Thirty patients (96.8%) in group I and 36 (100%) in group II had <5 mm of difference according to the KT-1000 arthrometer. Twenty-nine patients (93.5%) in group I and 34 (94.4%) in group II were normal or nearly normal according to the 2000 IKDC knee examination.

Conclusion

ACL reconstruction with fresh-frozen tibialis tendon allograft produced a reliable and predictable outcome after the short-term follow-up. The two methods used for femoral fixation produced similar outcomes.

Keywords: ACL, Reconstruction, Tibialis tendon allograft, Femoral fixation method

Figures and Tables

Fig. 1

Endopearl was sutured to the proximal end of the double-stranded tibialis tendon allograft (A). A whipstitch was done except for the intra-articular portion of the graft (A, B).

Fig. 2

The tibial drill guide was set to 30-40° in horizontal plane (A) and at 40-45° in the sagittal plane (B). The starting point for the guide pin on the proximal tibia was proximal to the pes anserinus and anterior to the medial collateral ligament. TT, tibial tuberosity.

Fig. 3

The intraarticular guide tip was located approximately 1 mm anterior and medial to the conventional site, which was the inner margin of the lateral meniscus anterior horn and just the lateral side of the medial tibial spine. LM, lateral meniscus; ACL, anterior cruciate ligament.

Table 1

Results of the Lysholm Score and 2000 IKDC Subjective Knee Score

Table 2

Results of the Objective Tests

Table 3

Results of the 2000 IKDC Knee Examination

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