Transcondylar screw fixation in anterior cruciate ligament reconstruction.

Abstract

The purpose of this study was to investigate the outcomes of 2 different methods of femoral fixation for arthroscopically assisted anterior cruciate ligament (ACL) reconstruction. Double-blind prospective study. Fifty-five patients were prospectively evaluated at 2-year follow-up. In group A, 24 patients underwent arthroscopic ACL reconstruction with bone-patellar tendon-bone and interference screw fixation. In group B, 31 patients underwent arthroscopic ACL reconstruction with bone-patellar tendon-bone and transcondylar screw fixation. Patients were evaluated by using the IKDC form, Lysholm-II form, Tegner scoring system, and KT-2000 arthrometer. In group A, final IKDC clinical evaluation achieved 0% grade A, 62.5% grade B, 25% grade C, and 12.5% grade D. In group B, 29.1% achieved grade A, 54.8% grade B, 12.9% grade C, and 3.2% grade D. The difference was statistically significant (P <.05). The injured versus normal side-to-side KT-2000 difference at maximum manual loading was 3.68 mm (SD, 1.71) in group A and 1.64 (SD, 2.05) in group B (P <.0001). This prospective study could not provide significant data suggesting that 1 method of fixation is superior to the other. Therefore, we consider both methods comparable in terms of stability and functional outcome at short-term follow-up. Transcondylar fixation offers the following advantages: fixation without intra-articular hardware, greater bone-to-bone fixation, and the possibility of fixation with breakage of the posterior femoral tunnel wall. Moreover, this method may be a useful alternative in revision ACL surgery.