No Difference in Bone Tunnel Enlargement and Clinical Outcome between Cortical Suspension and Hybrid Femoral Fixation in Hamstring Anterior Cruciate Ligament Reconstruction
Objective The best method for femoral fixation in anterior cruciate ligament reconstruction (ACLR) remains controversial. The study assesses the bone tunnel enlargement and clinical outcome in hamstring ACLR using cortical suspension or hybrid (cortical suspension and compression) femoral fixation....
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2024-04-01
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| Series: | Orthopaedic Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/os.14024 |
| _version_ | 1797231068554723328 |
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| author | Yucheng Lin Lu Zhang Sinuo Shen Yuzhi Chen Li Xu Mingliang Ji Yudong Guo Jinan Wei Yonggang Li Xiaotao Wu Jun Lu |
| author_facet | Yucheng Lin Lu Zhang Sinuo Shen Yuzhi Chen Li Xu Mingliang Ji Yudong Guo Jinan Wei Yonggang Li Xiaotao Wu Jun Lu |
| author_sort | Yucheng Lin |
| collection | DOAJ |
| description | Objective The best method for femoral fixation in anterior cruciate ligament reconstruction (ACLR) remains controversial. The study assesses the bone tunnel enlargement and clinical outcome in hamstring ACLR using cortical suspension or hybrid (cortical suspension and compression) femoral fixation. Methods From January 2010 to December 2021, 102 patients who underwent quadruple hamstring ACLR using cortical suspension (39 patients) or hybrid (63 patients) fixation on the femoral side were retrospectively analyzed. Clinical evaluation was conducted using the international knee documentation committee score, the Lysholm score, the Tegner activity level scale, the knee injury and osteoarthritis outcome score (quality of life score), the Lachman test, and the side‐to‐side difference by the KT‐1000 arthrometer. The complications after the surgery were also evaluated. These data were compared at baseline and last follow‐up. The diameters of the femoral tunnel were calculated at three sites: the width of the entrance of the femoral tunnel, 1 cm proximal to the entrance of the femoral tunnel and the largest diameter of the femoral tunnel on magnetic resonance imaging (MRI) coronal images. Bone tunnel widening data were contrasted between MRI images conducted at least 2 years and within 2 weeks after surgery. The morphology of bone tunnel enlargement was also observed and recorded. The categorical parameters were analyzed using the χ2‐test and Fisher's exact test. The continuous variables conforming to a normal distribution were analyzed using Student's t‐test, and the Mann–Whitney U‐test was undertaken between the two groups without normal distribution. Results Both cortical suspension and hybrid femoral fixation in quadruple hamstring ACLR achieved significantly improved patient‐reported outcome scores and knee stability compared to preoperative data. However, no significant differences were found between these two methods in clinical evaluations, postoperative complications, and patient‐reported outcome scores. Although the mean diameter of the enlarged bone tunnel was lowered by an additional bioabsorbable interference screw fixation near the joint line, a statistically insignificant difference was found between the hybrid and cortical suspension fixation on the femoral side. There was no statistical difference in the distribution of enlarged bone tunnel morphology between groups. Conclusions No significant difference was found in the bone tunnel enlargement and clinical outcome between cortical suspension and hybrid femoral fixation in ACLR using hamstring autograft. |
| first_indexed | 2024-04-24T15:38:30Z |
| format | Article |
| id | doaj.art-164b1f6044794f2084ae8f685df4cb25 |
| institution | Directory Open Access Journal |
| issn | 1757-7853 1757-7861 |
| language | English |
| last_indexed | 2024-04-24T15:38:30Z |
| publishDate | 2024-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | Orthopaedic Surgery |
| spelling | doaj.art-164b1f6044794f2084ae8f685df4cb252024-04-02T01:03:25ZengWileyOrthopaedic Surgery1757-78531757-78612024-04-0116490291110.1111/os.14024No Difference in Bone Tunnel Enlargement and Clinical Outcome between Cortical Suspension and Hybrid Femoral Fixation in Hamstring Anterior Cruciate Ligament ReconstructionYucheng Lin0Lu Zhang1Sinuo Shen2Yuzhi Chen3Li Xu4Mingliang Ji5Yudong Guo6Jinan Wei7Yonggang Li8Xiaotao Wu9Jun Lu10Department of Orthopaedic Surgery Zhongda Hospital, School of Medicine, Southeast University Nanjing ChinaDepartment of Anesthesiology Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital Nanjing ChinaDepartment of Orthopaedic Surgery Zhongda Hospital, School of Medicine, Southeast University Nanjing ChinaDepartment of Orthopaedic Surgery Zhongda Hospital, School of Medicine, Southeast University Nanjing ChinaDepartment of Orthopaedic Surgery Zhongda Hospital, School of Medicine, Southeast University Nanjing ChinaDepartment of Orthopaedic Surgery Zhongda Hospital, School of Medicine, Southeast University Nanjing ChinaDepartment of Orthopaedic Surgery Zhongda Hospital, School of Medicine, Southeast University Nanjing ChinaDepartment of Orthopaedic Surgery Zhongda Hospital, School of Medicine, Southeast University Nanjing ChinaDepartment of Orthopaedic Surgery Zhongda Hospital, School of Medicine, Southeast University Nanjing ChinaDepartment of Orthopaedic Surgery Zhongda Hospital, School of Medicine, Southeast University Nanjing ChinaDepartment of Orthopaedic Surgery Zhongda Hospital, School of Medicine, Southeast University Nanjing ChinaObjective The best method for femoral fixation in anterior cruciate ligament reconstruction (ACLR) remains controversial. The study assesses the bone tunnel enlargement and clinical outcome in hamstring ACLR using cortical suspension or hybrid (cortical suspension and compression) femoral fixation. Methods From January 2010 to December 2021, 102 patients who underwent quadruple hamstring ACLR using cortical suspension (39 patients) or hybrid (63 patients) fixation on the femoral side were retrospectively analyzed. Clinical evaluation was conducted using the international knee documentation committee score, the Lysholm score, the Tegner activity level scale, the knee injury and osteoarthritis outcome score (quality of life score), the Lachman test, and the side‐to‐side difference by the KT‐1000 arthrometer. The complications after the surgery were also evaluated. These data were compared at baseline and last follow‐up. The diameters of the femoral tunnel were calculated at three sites: the width of the entrance of the femoral tunnel, 1 cm proximal to the entrance of the femoral tunnel and the largest diameter of the femoral tunnel on magnetic resonance imaging (MRI) coronal images. Bone tunnel widening data were contrasted between MRI images conducted at least 2 years and within 2 weeks after surgery. The morphology of bone tunnel enlargement was also observed and recorded. The categorical parameters were analyzed using the χ2‐test and Fisher's exact test. The continuous variables conforming to a normal distribution were analyzed using Student's t‐test, and the Mann–Whitney U‐test was undertaken between the two groups without normal distribution. Results Both cortical suspension and hybrid femoral fixation in quadruple hamstring ACLR achieved significantly improved patient‐reported outcome scores and knee stability compared to preoperative data. However, no significant differences were found between these two methods in clinical evaluations, postoperative complications, and patient‐reported outcome scores. Although the mean diameter of the enlarged bone tunnel was lowered by an additional bioabsorbable interference screw fixation near the joint line, a statistically insignificant difference was found between the hybrid and cortical suspension fixation on the femoral side. There was no statistical difference in the distribution of enlarged bone tunnel morphology between groups. Conclusions No significant difference was found in the bone tunnel enlargement and clinical outcome between cortical suspension and hybrid femoral fixation in ACLR using hamstring autograft.https://doi.org/10.1111/os.14024anterior cruciate ligament reconstructionbone tunnel enlargementclinical outcomecortical suspension fixationhybrid femoral fixation |
| spellingShingle | Yucheng Lin Lu Zhang Sinuo Shen Yuzhi Chen Li Xu Mingliang Ji Yudong Guo Jinan Wei Yonggang Li Xiaotao Wu Jun Lu No Difference in Bone Tunnel Enlargement and Clinical Outcome between Cortical Suspension and Hybrid Femoral Fixation in Hamstring Anterior Cruciate Ligament Reconstruction Orthopaedic Surgery anterior cruciate ligament reconstruction bone tunnel enlargement clinical outcome cortical suspension fixation hybrid femoral fixation |
| title | No Difference in Bone Tunnel Enlargement and Clinical Outcome between Cortical Suspension and Hybrid Femoral Fixation in Hamstring Anterior Cruciate Ligament Reconstruction |
| title_full | No Difference in Bone Tunnel Enlargement and Clinical Outcome between Cortical Suspension and Hybrid Femoral Fixation in Hamstring Anterior Cruciate Ligament Reconstruction |
| title_fullStr | No Difference in Bone Tunnel Enlargement and Clinical Outcome between Cortical Suspension and Hybrid Femoral Fixation in Hamstring Anterior Cruciate Ligament Reconstruction |
| title_full_unstemmed | No Difference in Bone Tunnel Enlargement and Clinical Outcome between Cortical Suspension and Hybrid Femoral Fixation in Hamstring Anterior Cruciate Ligament Reconstruction |
| title_short | No Difference in Bone Tunnel Enlargement and Clinical Outcome between Cortical Suspension and Hybrid Femoral Fixation in Hamstring Anterior Cruciate Ligament Reconstruction |
| title_sort | no difference in bone tunnel enlargement and clinical outcome between cortical suspension and hybrid femoral fixation in hamstring anterior cruciate ligament reconstruction |
| topic | anterior cruciate ligament reconstruction bone tunnel enlargement clinical outcome cortical suspension fixation hybrid femoral fixation |
| url | https://doi.org/10.1111/os.14024 |
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