Aim of the study
The aim of this study was to compare the results both clinically and radiologically in patients undergoing anterior cruciate ligament (ACL) reconstruction using two different methods of graft fixation.
Patients and methods
In a retrospective way, at Mansoura knee surgery unit, 120 patients underwent ACL reconstruction with hamstring graft with the use of an interference screw fixation in both the femoral and the tibial tunnel in 60 patients (group A) and rigid fix fixation in the femoral tunnel and screw and washer fixation distal to the tibial tunnel in another 60 patients (group B). The evaluation included International Knee Documentation Committee ratings, Lysholm score, and standardized radiographs, MRI. The diameter of the tunnel on MRI was compared with the tunnel diameter obtained from the operative sheet.
Results
No significant difference in clinical results was found with using Lysholm score and International Knee Documentation Committee between the two groups. Radiologically, in group A, eight patients had developed femoral tunnel widening and four had developed tibial tunnel widening. In group B, 12 patients had tunnel widening in the femur and 20 in the tibia. There was a significant reduction of tunnel widening in the tibia using interference screw fixation compared with the fixation by screw and washer distal to the tibial tunnel.
Conclusion
The position of the fixation sites and type of fixation device are major factors in the development of tunnel widening after ACL surgery, but they do not significantly affect the clinical results.