2017 ISAKOS Biennial Congress ePoster #1014

 

The Influence of Graft Fixation Methods on Revision Rates after Primary ACL Reconstruction. A National Registry Study

Niclas Højgaard Eysturoy, Cand. Med., Aarhus C DENMARK
Torsten G. Nielsen, BSc, Aarhus N DENMARK
Martin Lind, MD, PhD, Prof., Aarhus N DENMARK

Sportstrauma Div, Dept of Orthopedics, Aarhus University Hospital, Aarhus , DENMARK

FDA Status Not Applicable

Summary

A national registry study, investigating the short term risk of revision in primary ACL reconstruction depending on graft fixation method by principle and by frequently used fixation combinations.

Abstract

Introduction

The method of graft fixation in primary anterior cruciate ligament (ACL) reconstruction is important for the initial stability of the graft. Poor graft fixation can result in failure of the reconstruction. This study investigates the early risk of revision depending on graft fixation principle and the most frequently used combinations of graft fixation implants in a national patient cohort. METHODS: Revision rates and graft fixation method was extracted from The Danish ACL Reconstruction Registry (DKRR). Analyses included hamstring tendon- (HT) and patellar tendon grafts (PT). Revisions after 2 years and multiligament reconstructions were excluded. 14.935 patients were included in the study. Failure outcome was 2-years revision rate. We extracted data from both principle of graft fixation in the femur and all implant combinations represented by more than 175 patients. RESULTS: Analysis of fixation principles demonstrated that non-adjustable suspension technique had a higher higher risk of revision (RR=1,27), while the transfixation technique had a lower risk (RR:0.78). Comparing frequent fixation combinations, Endobutton/Biosure PEEK (RR: 1,36) and Endobutton/Intrafix Bio (RR:1,55) had higher risk for revision for HT reconstructions. Atlantec metal screw/metal screw (RR: 0,83) and Softsilk/Softsilk (RR:0,73) had a lower risk for revision for PT reconstructions. CONCLUSION: A non-adjustable suspension fixation technique has a higher risk, while transfixation has a lower risk of revision within 2 years after a primary ACL reconstruction. For HT reconstructions, the fixation combinations of Endobutton/BioSure PEEK and Endobutton/Intrafix had a higher risk, while for PT reconstructions Atlantec metal screw/metal screw and Softsilk/Softsilk screw had a lower risk of revision.