Tibial bone tunnel widening is reduced by polylactate/hydroxyapatite interference screws compared to metal screws after ACL reconstruction with hamstring grafts.
Composite interference screws containing calcium phosphate for anterior cruciate ligament graft fixation could improve implant/bone integration and thereby reduced tunnelwidening and graft slippage. The present study investigated the effect of polylactate/hydroxyapatite interference screw (HA/PLLA) screw used for tibial graft fixation on tunnel widening and clinical outcomes compared with a metal interference screw. We hypothesized less tibial tunnelwidening with HA/PLLA screws compared to metal screws. Hundred patients with HA/PLLA screw tibial fixation was compared with 100 patients with metal screw tibial fixation. Tibial tunnel widening was measured on AP and lateral radiographs taken at 12 months follow-up. Clinical outcome was assessed by objective and subjective international Knee Documentation Committee (IKDC) scores, Noyes Sports Activity and Occupational Rating scores and KT-1000 knee laxity measurements. Tibial tunnel widening at the level of the metal screw group was 36% and 38% on AP and lateral radiographs respectively. Tunnel widening was lower in the HA/PLLA group with mean tunnel widening of 30% and 32% (p=0.012 and 0.018) on AP and lateral radiographs respectively. No differences were found for any of the clinical scores or for anterior knee laxity. The use of a polylactate/hydroxyapatite interference screw resulted in less tibial tunnel widening than a metal screw around the screw but did not affect clinical outcome or objective knee laxity.
Lind
Martin
M
Division of Sportstrauma, Orthopaedic Department, Aarhus University Hospital, Tage Hansensgade 2, 8000 Aarhus C, Denmark. Martinlind@dadlnet.dk
Feller
Julian
J
Webster
Kate E
KE
D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D001672:Biocompatible Materials; D001863:Bone Screws; D016022:Case-Control Studies; D017886:Durapatite; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008022:Ligaments / Q000637:transplantation*; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000534:rehabilitation; D011091:Polyesters; D011859:Radiography; D020127:Recovery of Function; D013977:Tibia / Q000000981:diagnostic imaging* / Q000601:surgery*; D019737:Transplants; D055815:Young Adult
D001672:Biocompatible Materials; D011091:Polyesters; C499699:hydroxyapatite-polylactide; D017886:Durapatite