Fixation with Biodegradable Interference Screw and Bone Block to Femoral Tunnel in Arthroscopic ACL Reconstruction using Autogenous Hamstring Tendon

Seo, Seung Suk; You, Sung Jin; Choi, Jang Seok; Kim, Young Chang

Abstract

PURPOSE
The purpose of this study is to report the postoperative clinical results after arthroscopic ACL reconstruction using quadrupled hamstring autograft fixed with biodegradable interference screw and bone block in the femoral tunnel.
MATERIALS AND METHODS
Between January and December 1997, we performed an arthroscopic ACL reconstruction with quadrupled hamstring autograft in twenty one patients. To enhance the mechanical stability in the femoral tunnel the graft was fixed with a biodegradable interference screw and cortical bone block which was harvested from the proximal tibial metaphysis. The tibial side of graft was tied at the post of an AO cortical screw. Postoperatively the patients were permitted an accelerated rehabilitation with motion brace. The results were evaluated with IKDC form, complications and radiologic findings. The average follow-up was 36 months.
RESULTS
Patient subjective assessment was graded normal in 4, nearly normal in 8, abnormal in 7, severe abnormal in 2. Ligament evaluation was graded normal in 16, nearly normal in 3, abnormal in 1, severe abnormal in 1. Harvest site pathology was graded normal in 16, nearly normal in 4, abnormal in 1. Functional test was graded normal in 6, nearly normal in 8, abnormal in 4, severe abnormal in 3. Radiologic findings showed an average 22% increase in the tibial tunnel diameter. Postoperative complications were one recurrent patholaxity, deep infection and arthrofibrosis required operation in each.
CONCLUSION
Arthroscopic ACL reconstruction using quadrupled hamstring autograft fixed with biodegradable interference screw and bone block in the femoral tunnel provided with excellent ligament stability and permitted the early accelerated rehabilitation.