title: Femoral press-fit fixation technique in anterior cruciate ligament reconstruction using bone-patellar tendon-bone graft: a prospective clinical evaluation of 285 patients.
abstract: BACKGROUND
  The security of the graft fixation is an important factor of anterior cruciate ligament reconstruction, especially in the early postoperative period.
  
  
  OBJECTIVE
  The femoral press-fit fixation technique is a safe, alternative technique for the fixation of the bone-patellar tendon-bone graft.
  
  
  METHODS
  Case series; Level of evidence, 4.
  
  
  METHODS
  Between January 1, 1998, and June 30, 2002, 285 patients, with a mean age of 29.1 years, underwent operation and observation in our department. All patients had arthroscopic anterior cruciate ligament reconstruction using bone-patellar tendon-bone graft with femoral press-fit and tibial interference screw fixation. The mean follow-up period was 35.8 months (range, 24-77 months). During each patient's evaluation, a physical examination, a subjective evaluation, the International Knee Documentation Committee and Lysholm scores, KT-1000 arthrometer testing, and radiological evaluation were performed. The paired Student t test or chi(2) test was used for statistical analysis.
  
  
  RESULTS
  According to the International Knee Documentation Committee score, 241 patients (85%) had good (46 normal and 195 nearly normal) results, whereas 39 patients had abnormal and 5 patients had severely abnormal overall results. The preoperative mean Lysholm score was 63.5 +/- 12.7 points. At the final examination, the mean value was 93.5 +/- 7.8 points (P < .01). One hundred ninety-seven athletes could return to their previous sports activity level, whereas 13 patients gave up their sports career. The KT-1000 arthrometer results showed a side-to-side difference of 1.91 +/- 2.1 mm at the maximum manual strength tests.
  
  
  CONCLUSIONS
  The femoral press-fit fixation is an alternative fixation method for the bone-patellar tendon-bone graft and provides good stability for the anterior cruciate ligament reconstruction. The use of press-fit fixation technique avoids most interference screw or other hardware-induced complications at the femoral side.
authors.affiliation: National Institute for Sports Medicine, Department of Sports Surgery, Budapest, Hungary. pavlika@t-online.hu
authors.forename: Attila
authors.initials: A
authors.lastname: Pavlik
authors.forename: Péter
authors.initials: P
authors.lastname: Hidas
authors.forename: András
authors.initials: A
authors.lastname: Tállay
authors.forename: József
authors.initials: J
authors.lastname: Toman
authors.forename: István
authors.initials: I
authors.lastname: Berkes
mesh_terms: D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D001178:Arthroplasty / Q000295:instrumentation / Q000379:methods*; D050376:Bone-Patellar Tendon-Bone Grafting / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016268:Internal Fixators; D007718:Knee Injuries / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome