Comparison between suspensory and aperture (Tunnel Screws) fixation of femoral component during anterior cruciate ligament reconstruction using hamstring tendons

Abstract

Introduction: Arthroscopic reconstruction of the anterior cruciate ligament (ACL) using an autogenous quadrupled hamstring graft has been the standard of surgical treatment in ACL-deficient knees, particularly in young athletic individuals. There are two widely used methods for graft fixation, namely aperture fixation and suspensory fixation. Material and Methods: This prospective randomized single blinded clinical study was carried out with enrollment of 70 patients (35 patients in each group) who underwent simple block randomization process. Group 1 has 35 patients treated with suspensory fixation technique and Group 2 has 35 patients treated with aperture fixation technique. Result: It is observed that there is a statistically significant difference between the mode of injury and diagnosis in suspensory method. In the majority of the cases, patients who got injury by road traffic accidents (RTA) was diagnosis by 15 (51.7%) ACL Grade 3 and 3 (60%) ACL Grade 4. It is observed that there is a statistically significant difference between the mode of injury and diagnosis in screw fixation. In the majority of the cases, patients who got injury by RTA was diagnosis by 1 (100%) ACL Grade 2, 15 (51.7%) ACL Grade 3, and 3 (60%) ACL Grade 4. Conclusion: Arthroscopy-assisted ACL reconstruction with quadrupled semitendinosus tendon autograft using endobutton and bioabsorbable interference screw is an excellent treatment option for ACL-deficient knees.

Keywords

• aperture method
• bioabsorbable
• hamstring graft
• randomization
• suspensory method