Is Aperture Fixation Superior to Cortical Fixation for Quadruple Hamstring Graft in Anterior Cruciate Ligament Reconstruction?
Journal Title: National Journal of Clinical Orthopaedics - Year 2018, Vol 2, Issue 1
Abstract
Introduction: ACL is a commonly injured ligament of the knee. The incidence is rising due to increased motor vehicle accident. To regain full activity, its proper reconstruction is essential. Different technique developed over time to fix the graft to femur and tibia. Our study has compared the result of two fixation technique i.e. aperture fixation and cortical fixation. Materials and Methods: In this prospective comparative study 60 patients were randomised into two groups. In group one (n=30) graft was fixe d using aperture fixation and in group 2 (n=30), using cortical fixation. All were followed at two, four, eight weeks and 6 months for evaluation by IKDC scoring, LYSHOLAM scoring, KT1000 arthrometer and measurement of tunnel widening. Results: Both IKDC score and LYSHOLM score were better in aperture fixation group as compared to cortical fixation group at 6 month followup. The anterior translation of tibia was measured using KT 1000 arthrometer at 6 months. In our study, preoperatively we found significant difference between affected and unaffected knee at each force. Postoperatively we found there is no difference in KT-1000 reading between knees at each follow up. Aperture fixation group was also associated with less tunnel widening post operatively. Conclusion: Aperture fixation method for ACL reconstruction provided a better LYSHOLAM, and IKDC score than cortical fixation. The tunnel widening at 6 months was less as compared to the cortical fixation group, as the anterior tibial translation. Thus, aperture fixation provides a strong and rigid fixation resulting in lesser chances of tunnel widening.
Authors and Affiliations
Anand M, Sharma BP, Kumar A
Keywords
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