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A randomised controlled study for  the comparison  of functional outcome of femoral tunnel fixation devices, aperture fixation by screw vs suspensory fixation by endo-button in arthroscopic anterior cruciate ligament reconstruction

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Original Article

Author Details : Paras Prajapati, Vishal Bansal, Ashish Tiwari, Mani Bagga, Sanjeev Mahawar*

Volume : 9, Issue : 2, Year : 2023

Article Page : 61-65

https://doi.org/10.18231/j.ijos.2023.015

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Abstract

Purpose: The goal of this study was to compare suspensory and aperture fixation methods for restoring soft tissue allografts in the anterior cruciate ligament (ACL).
Materials and Methods: 30 patients were chosen and randomly allocated to one of two experimental groups, suspensory fixation or aperture fixation, following the completion of a prospective analysis, permission from the institutional review board, and patient agreement. All of the patients underwent ACL reconstruction surgery using soft tissue allografts made of hamstring tendon. The procedures were either (1) femoral and tibial fixation with a femoral cannulated interference screw and a tibial cannulated interference screw (aperture) or (2) femoral cortical buttons (suspensory) and a tibial cannulated interference screw. The subjective anterior drawer test analysis and changes in the International Knee Documentation Committee knee examination rating were employed as end measures.
Results: All of the patients who had received treatment (100%) had successfully completed a clinical assessment at the 1-month, 4-month, 8-month, and 12-month follow-ups. Out of the 30 patients who were included, 15 (50%) underwent suspensory fixation treatment and the other 15 (50%) underwent aperture fixation treatment. The primary outcome measure—AP stability at 25 degrees of knee flexion—did not differ across groups at a 12-month follow-up. Also, at the 1-month and 4-month evaluations, secondary data revealed a statistically significant difference between the groups.
Conclusions: Our data showed no meaningful differences in knee AP stability or other outcomes between ACL allograft reconstruction using aperture fixation and ACL allograft reconstruction utilising suspensory fixation at the 12-month mark, while aperture fixation performed better at the first and fourth months. One of our main outcome measures was the grading of knee anteroposterior (AP) stability (clinical judgments).
Level of Evidence : Level II, lesser-quality randomised controlled trial with a follow-up of 1 year.
 

Keywords: ACL reconstruction, Suspensory v/s apurture, Screw v/s endo-button.

How to cite : Prajapati P, Bansal V, Tiwari A, Bagga M, Mahawar S, A randomised controlled study for  the comparison  of functional outcome of femoral tunnel fixation devices, aperture fixation by screw vs suspensory fixation by endo-button in arthroscopic anterior cruciate ligament reconstruction. Indian J Orthop Surg 2023;9(2):61-65

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