2025 ISAKOS Biennial Congress ePoster
Short And Proximalized Interferencial Screw Fixation Lead To Tibial Tunnel Bone Re-Growth And Better Hamstring Graft Integration In Acl Reconstruction.
Francisco J. Simón-Sánchez, MD, Barcelona SPAIN
Simone Perelli, MD,PhD, Barcelona SPAIN
Nicola Pizza, MD, Barcelona SPAIN
Michelangelo Delmedico, MD, Milano ITALY
Rodolfo Morales-Avalos, MD, MSc, PhD., Monterrey, NL MEXICO
Raúl Torres-Claramunt, PhD, Barcelona SPAIN
Joan Carles Monllau, MD, PhD, Prof., Barcelona, Barcelona SPAIN
HOSPITAL UNIVERSITARIO DEXEUS. ICATME, Barcelona, Barcelona, SPAIN
FDA Status Not Applicable
Summary
At 6 months postoperative MRI, tibial bone tunnel re-growth and graft-tunnel tibial integration after hamstring ACLR is significantly associated with the presence of a free space between the anterior tibial cortex and the most distal portion of the interference screw, hence the use of a short and proximalized interferencial screw is suggested to restore bone stock after hamstring ACLR
Abstract
Purpose
Stability of the graft in the bony tunnels is of outmost importance in anterior cruciate ligament (ACL) reconstruction since it ensures a safe healing at the tendon-bone interface. The hypothesis was that when a double tibial fixation was used in ACL reconstruction with autologous hamstrings, tibial bone tunnel re-growth and better graft integration would be observed at short term follow up.
Methods
A cohort of 112 patients who underwent primary ACLR with hamstring had undergone postoperative MRI (3.0-T) at 6 months after the surgery was included for analysis. The patients were divided into three groups based on the tibial fixation technique: 40 had a screw (group S), 35 had screw and metal button (group S+B), 37 had a screw and anchor (group S+A). The images were independently evaluated by two orthopaedic specialists that measured the screw-free tunnel space and assessed the existence or not of bone filling in the free tunnel. Furthermore, the protocol described by Ge was used to determine the graft healing in the tunnel.
Results
In 94 patients a screw-free tunnel space was detected, and a filling of the tunnel was reported in 80.85% of the cases (76 patients), being partial in 15.79% (12 patients) of the cases and complete in 84.21% (64 patients) of the cases.Patients which presented better graft integration (GE1) had significantly higher value
of screw-free tunnel length compared to the other ones that had lower graft integration (GE3) (p<0.05)
Conclusions
At 6 months postoperative MRI, tibial bone tunnel re-growth and graft-tunnel tibial integration after hamstring ACL reconstruction is significantly associated with the presence of a free space between the anterior tibial cortex and the most distal portion of the interference screw, hence the use of a short and proximalized interferencial screw is suggested to restore bone stock after hamstring ACL reconstruction.