title: Tibial fixation in anterior cruciate ligament reconstruction with bone-patellar tendon-bone and semitendinosus-gracilis autografts: a comparison between bioabsorbable screws and bioabsorbable cross-pin fixation.
abstract: BACKGROUND
  Knee instability after anterior cruciate ligament reconstruction rarely manifests with activities of daily living, but it may occur in high-level sports performance, resulting in secondary injuries. Faced with these circumstances, sports orthopaedists have continued to improve on the results obtained with surgical techniques for treating knee joint injuries.
  
  
  OBJECTIVE
  Transverse tibial fixation with bioabsorbable cross pins is a valid technique for anterior cruciate ligament reconstruction with both the patellar tendon (bone-patellar tendon-bone) and semitendinosus and gracilis tendon.
  
  
  METHODS
  Cohort study; Level of evidence, 3.
  
  
  METHODS
  The study population was 120 patients operated on by the same surgeon and subdivided into 4 subgroups of 30 subjects each. Patients were chosen and assigned to each group consecutively. Patients in group 1 (bone-patellar tendon-bone) were implanted with bioabsorbable interference screws, group 2 (bone-patellar tendon-bone) received 2 bioabsorbable cross pins, group 3 (semitendinosus and gracilis tendon) received a bioabsorbable interference screw, and group 4 (semitendinosus and gracilis tendon) received 2 bioabsorbable cross pins. Patients were assessed at 5-year follow-up for International Knee Documentation Committee Knee Ligament Standard Evaluation Form, Lysholm Knee Scoring Scale, Lysholm-Tegner Activity Scale, and KT-1000 arthrometer testing.
  
  
  RESULTS
  The results at 5 years after anterior cruciate ligament reconstruction were similar across all 4 groups. No significant differences have been observed between groups.
  
  
  CONCLUSIONS
  The results suggest that transverse tibial fixation with bioabsorbable cross pins is a safe and reliable procedure, yielding clinical results that are comparable with those of the more widely used bioabsorbable interference screws.
authors.affiliation: IRCCS Galeazzi Orthopaedic Institute, Milan, Italy. volpi.piero@libero.it
authors.forename: Piero
authors.initials: P
authors.lastname: Volpi
authors.forename: Luca
authors.initials: L
authors.lastname: Marinoni
authors.forename: Corrado
authors.initials: C
authors.lastname: Bait
authors.forename: Marco
authors.initials: M
authors.lastname: Galli
authors.forename: Laura
authors.initials: L
authors.lastname: de Girolamo
mesh_terms: D020341:Absorbable Implants; D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery; D001178:Arthroplasty / Q000295:instrumentation* / Q000379:methods; D001858:Bone Nails; D001863:Bone Screws; D050376:Bone-Patellar Tendon-Bone Grafting / Q000295:instrumentation*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013977:Tibia / Q000601:surgery*; D014182:Transplantation, Autologous; D055815:Young Adult