Fixation of patellar tendon bone graft in reconstruction of patellar ligaments. Comparison of bioabsorbable and metal interference screws--results of treatment.
BACKGROUND
The central third of the patella tendon is probably the most common ACL graft material because the bone tendon bone (BTB) construct provides robust graft incorporation and a mechanically sufficient substitute. Metal and bioabsorbable interference screws ensure good initial fixation strength of the bone plug.


METHODS
A total of 78 patients (mean age 29 years) were assigned to a bioabsorbable screw [L-15 Lactosorb] group (Group I of 34 patients) or a metal screw group (Group II of 44 patients). Mean follow-up was 3 years. This study compared the results of ACL reconstruction using bioabsorbable and metal interference screws. Pre- and postoperative assessments included patient history, the Lysholm Knee Scoring Scale and IKDC scores. Range of motion in the knee was measured. Magnetic resonance imaging was performed in 12 patients from each group.


RESULTS
Mean Lysholm scores at one year were 94.2 for Group I and 93.5 for Group II. After 3 years mean scores were 95.4 for Group I and 96.2 for Group II. A comparison of IKDC scores showed no statistically significant difference between groups. No radiographic evidence of osteolytic change or bone resorption around the metal screw was observed in Group II, whereas osteolytic changes around bioscrews were observed in 2 patients in Group I. There were no complications related to loss of fixation. The clinical signs of a foreign body reaction were found in one patient.


CONCLUSIONS
Bioabsorbale and metal interference screws produce equal clinical results. Complete degradation of a bioabsorbable screw takes 2-3 years.
Płomiński
Janusz
J
Department of Orthopaedics Central Clinical Hospital of the Ministry of National Defence, Medical Institute of the Health Services, Warsaw. plominsky@poczta.onet.pl
Borcz
Konrad
K
Kwiatkowski
Krzysztof
K
Zabicka
Magdalena
M
D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D001672:Biocompatible Materials; D001863:Bone Screws; D016025:Bone Transplantation; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008670:Metals; D017847:Patellar Ligament / Q000637:transplantation*; D019651:Plastic Surgery Procedures / Q000379:methods*; D016896:Treatment Outcome
D001672:Biocompatible Materials; D008670:Metals