title: Can an adjustable-loop length suspensory fixation device reduce femoral tunnel enlargement in anterior cruciate ligament reconstruction? A prospective computer tomography study.
abstract: BACKGROUND
  The aim of this study was to compare bone femoral tunnel enlargement in patients who underwent anterior cruciate ligament (ACL) transtibial reconstruction using an adjustable-loop length suspensory fixation device and a fixed-loop length suspensory fixation device.
  
  
  METHODS
  All patients treated for ACL reconstruction with an ipsilateral hamstring between March 2013 and March 2014 were evaluated. Subjects were assigned to Group A (TightRope™ (TR) femoral fixation) or Group B (EndoButton® (EB) femoral fixation). All patients were evaluated with the Lachman test, pivot-shift test, 2000 International Knee Documentation Committee (IKDC) knee examination and KT1000 arthrometer. The subjective evaluation was performed using the 2000 IKDC Subjective Knee score, the Lysholm knee score, and the Tegner activity scale. CT examination was performed to evaluate femoral tunnel enlargement at four different levels. All patients were assessed at a 12month follow-up visit. Power analysis was performed a priori in accordance with the femoral tunnel enlargement values from the CT scans. Differences with P-values of ≤0.05 were considered to be statistically significant.
  
  
  RESULTS
  The groups were homogenous at baseline with regard to age, gender, BMI, dominance and disease duration. At the final follow-up, no statistically significant differences (P>0.05) were found according to subjective and objective clinical outcome measures. According to the femoral tunnel enlargement, no statistically significant difference was found between the two groups (P>0.05).
  
  
  CONCLUSIONS
  In transtibial ACL reconstruction, the use of a fixed or adjustable-loop length device products, on the femoral side, led to similar clinical and radiological results.
authors.affiliation: Orthopaedic Unit and "Kirk Kilgour" Sports Injury Centre, S. Andrea Hospital, University of Rome "La Sapienza", Italy, Via di Grottarossa 1035, 00189 Rome, Italy. Electronic address: riccardolanzetti@gmail.com.
authors.forename: R M
authors.initials: RM
authors.lastname: Lanzetti
authors.affiliation: Orthopaedic Unit and "Kirk Kilgour" Sports Injury Centre, S. Andrea Hospital, University of Rome "La Sapienza", Italy, Via di Grottarossa 1035, 00189 Rome, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Monaco
authors.affiliation: Orthopaedic Unit and "Kirk Kilgour" Sports Injury Centre, S. Andrea Hospital, University of Rome "La Sapienza", Italy, Via di Grottarossa 1035, 00189 Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: De Carli
authors.affiliation: Villa Valeria Clinic, Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Grasso
authors.affiliation: Orthopaedic Unit and "Kirk Kilgour" Sports Injury Centre, S. Andrea Hospital, University of Rome "La Sapienza", Italy, Via di Grottarossa 1035, 00189 Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Ciompi
authors.affiliation: Orthopaedic Unit and "Kirk Kilgour" Sports Injury Centre, S. Andrea Hospital, University of Rome "La Sapienza", Italy, Via di Grottarossa 1035, 00189 Rome, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Sigillo
authors.affiliation: Diagnostic Imaging Unit, S. Andrea Hospital, University of Rome "La Sapienza", Italy, Via di Grottarossa 1035, 00189 Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Argento
authors.affiliation: Orthopaedic Unit and "Kirk Kilgour" Sports Injury Centre, S. Andrea Hospital, University of Rome "La Sapienza", Italy, Via di Grottarossa 1035, 00189 Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Ferretti
mesh_terms: D000328:Adult; D000070598:Anterior Cruciate Ligament Injuries / Q000601:surgery*; D059549:Anterior Cruciate Ligament Reconstruction / Q000295:instrumentation* / Q000379:methods; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D009984:Orthopedic Fixation Devices; D011446:Prospective Studies; D013710:Tendons / Q000637:transplantation; D013977:Tibia / Q000601:surgery; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: ACL; Femoral tunnel; Suspensory fixation device; Tunnel widening