Patellar tendon anterior cruciate ligament reconstruction with conical press-fit femoral fixation: 5-year results in athletes population.
Bone-patellar tendon autograft is probably the most widely used graft for ACL reconstruction. Several methods for graft fixation have been described. To avoid intra-articular hardware we adopt biological fixation with a femoral conical press-fit fixation. A prospective study was performed on 40 consecutive active athletes who underwent ACL reconstruction with this technique by the same surgeon between November 1994 and September 1995 (mean follow-up 46 months, range 36-62). Results were evaluated by an independent examiner using radiography, computed tomography, subjective and objective evaluation, and isokinetic and functional strength tests. Assessment using the IKDC knee scoring revealed 85% of the patients with a normal or nearly normal knee joint; Tegner's score was 7.5 preoperatively and 6.0 postoperatively, with 60% of the athletes returning to the preinjury sport and level. No patients had instability, with 90% having less than 3 mm side-to-side difference on computerized analysis. The isokinetic test showed mild quadriceps deficit at 3 and 6 months, with no deficit at final follow-up; four patients complained of anterior knee pain and had a positive kneeling test. We found no graft dislocation. All cases showed radiological evidence of graft integration at 3 months time. Long-term results support this technique asx a simple, cost-effective, and reliable alternative for patellar tendon fixation in ACL reconstruction.
Gobbi
Alberto
A
Orthopedic Arthroscopic Surgery International, Via Amadeo, 24 Milan 20133, Italy. sportmd@tin.it
Diara
Alberto
A
Mahajan
Sanjeev
S
Zanazzo
Milco
M
Tuy
Benjamin
B
D000328:Adult; D016118:Anterior Cruciate Ligament / Q000503:physiopathology / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D001265:Athletic Injuries / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007717:Knee / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D009984:Orthopedic Fixation Devices; D011446:Prospective Studies; D011859:Radiography; D019651:Plastic Surgery Procedures; D020127:Recovery of Function / Q000502:physiology; D013710:Tendons / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000637:transplantation*; D013997:Time Factors