Abstract
Introduction: Graft selection for anterior cruciate ligament (ACL) reconstruction remains controversial. The use of hamstring graft is associated with less harvest site morbidity but concern has been expressed with tibial fixation for these grafts. We recently began to use the new IntrafixTM ACL tibial fastener with hamstring grafts. It claims greater pullout strength and greater graft contact with circumferential healing of the tendons to the bone tunnels. Our objective was to assess the short term functional results with the new fixation as well as donor site morbidity.
Methods: We reviewed 64 patients who had a primary ACL reconstruction (quadrupled semitendinosus and gracilis tendons with EndobuttonTM femoral fixation) performed at least six months previously. They were assessed using self-administered International Knee Documentation Committee (IKDC) knee evaluation forms and the Lysholm knee score.
Results: The average patient age was 25 years (range 16–49 years) with average follow-up of 10.5 months (range 7–15 months). There were 57 males and 7 females. Forty two patients returned the questionnaires and 26 patients returned for examination. Over half of the patients (38/64) had meniscal tears. The mean IKDC score was 82.6 (SD 13.0) and the mean Lysholm score was 85.0 (SD 12.6). Sixty nine percent of patients (29/42) had knees rated excellent or good using the Lysholm knee score. Eighty eight percent (23/26) of the patients examined had normal or nearly normal knee function as graded by the IKDC. No patient had anterior knee numbness. Four patients had arthroscopic debridement and washout for knee pain and two patients had a wound haematoma at the donor site.
Conclusions: The IntrafixTM ACL tibial fastener provides sufficient early fixation to allow patients undergo a standard accelerated rehabilitation regime, leading to good functional recovery at 6 months. Our choice of ACL graft also results in low donor morbidity.
The abstracts were prepared by Mr Ray Moran. Correspondence should be addressed to him at Irish Orthopaedic Associaton, Secretariat, c/o Cappagh National Orthopaedic Hospital, Finglas, Dublin 11.
