Femoral bioabsorbable cross-pin fixation in anterior cruciate ligament reconstruction.

摘要

PURPOSE: The purpose of this study was to retrospectively evaluate clinical results after arthroscopic anterior cruciate ligament (ACL) reconstruction by use of hamstring autograft with femoral fixation via 2 bioabsorbable cross pins (Rigidfix system; DePuy Mitek, Raynham, MA). METHODS: We evaluated the results of 117 knees (117 patients) that had been treated with arthroscopic ACL reconstruction by use of hamstring autograft with femoral fixation via 2 bioabsorbable cross pins from September 2001 to November 2002. The mean follow-up period was 26.9 months (range, 25 to 32 months). Patients were evaluated by the Lachman test, pivot-shift test, KT-2000 arthrometer (MEDmetric, San Diego, CA) test, Lysholm score, and International Knee Documentation Committee grade at the preoperative and follow-up examinations. Of the knees, 74 were assessed by second-look arthroscopy. RESULTS: The mean Lysholm score was 72.6 (range, 51 to 86) preoperatively and 93.7 (range, 71 to 99) postoperatively. On the basis of thefinal International Knee Documentation Committee grade, 75 knees were normal (A), 36 were nearly normal (B), 6 were abnormal (C), and none were severely abnormal (D). KT-2000 arthrometer analysis revealed that 112 knees (95.7%) were grade A or B, with a median laxity of 1.3 mm (range, 1 to 6 mm) at final follow-up. Of the 74 knees that were assessed by second-look arthroscopy, 52 had preserved good tension, 22 had some laxity, and none had graft failure or rupture. CONCLUSIONS: ACL reconstruction via 4-strand hamstring autograft with femoral fixation by use of 2 bioabsorbable cross pins eliminated anterior tibial translation in 93.1% of patients at a mean follow-up of 26.9 months. The bioabsorbable cross-pin femoral fixation method via hamstring tendon autograft can be effective, useful, and reproducible. LEVEL OF EVIDENCE: Level IV, therapeutic case series.