One-Year Serial Follow-up Magnetic Resonance Imaging Study of RigidFix for Femoral Fixation in Anterior Cruciate Ligament Reconstruction

PURPOSE: To assess graft slippage at the site of femoral fixation by follow-up magnetic resonance imaging (MRI) after anterior cruciate ligament (ACL) reconstruction with a four-strand autogenous hamstring tendon using RigidFix (DePuy Mitek). MATERIALS AND METHODS: Twenty-one subjects diagnosed with ACL rupture underwent ACL reconstruction using hamstring autograft with the transtibial technique. RigidFix was used for femoral fixation and Intrafix and washer screw were used for tibial fixation. Follow-up MRIs were taken immediately after surgery and at 1, 3, 6, and 12 months after surgery. Slippage of the graft and breakage of the RigidFix cross-pin were assessed. Side-to-side difference (SSD) on stress radiographs was measured to assess residual laxity. RESULTS: Mean slippage of the graft was 0.21±0.31 mm at one year after surgery. Cross-pin breakage was noted in two subjects: in one subject, immediately after surgery and in the other subject, at 6 months after surgery. Mean SSD was 1.32±1.07 mm at the last follow-up. The correlation coefficient between graft slippage and SSD was 0.131 (p=0.571). CONCLUSIONS: RigidFix is a stable fixation device for hamstring autograft with minimally statistically significant but clinically insignificant graft slippage. Cross-pin breakage did not affect the clinical outcomes. Careful preparation of the graft is needed for performing the technique correctly.

Comparison of anterior cruciate ligament reconstruction by Ethibond excel polyester sutures combined with high-strength sutures using RigidFix for autogenous tendons fixation / 中国内镜杂志

Objective To compare the effectiveness of anterior cruciate ligament (ACL) reconstruction using Rigid-Fix for autogenous tendons fixation between by Ethibond excel polyester sutures combined with high-strength sutures and by Ethibond excel polyester sutures. Methods From October 2011 to August 2013, 48 cases of ACL rupture underwent ACL reconstruction using RigidFix for autogenous tendons fixation. Ethibond excel polyester sutures combined with high-strength sutures were used in 25 cases (observation group) and Ethibond excel polyester sutures were used in 23 cases (control group). There was no significant difference in gender, age, side, disease duration, and preoperative Lachman test, Lysholm score, and the International Knee Documentation Committee (IKDC) score be-tween the two groups ( >0.05). While the treatment and rehabilitation measures were identical. Result The opera-tion performed smoothly. Vessel, nerve and meniscus were not injured. No complication of donor site pain and myas-thenia of affected knee after operation. At 6 months and 2 years after operation, the Lachman test, the Lysholm score and the IKDC score were superior significantly to those before operation in both groups ( 0.05). Conclusion Anterior cruciate ligament reconstruction by Ethibond excel polyester su-tures combined with high-strength sutures using RigidFix for autogenous tendons fixation presented satisfactory clinical results, whether using high-strength sutures during operation needs to be further study.

ACL Reconstruction with Autologous Hamstring Tendon: Comparison of Short Term Clinical Results between Rigid-fix and PINN-ACL Cross Pin

PURPOSE: To compare the short term clinical results of anterior cruciate ligament (ACL) reconstruction with autologous hamstring tendon between Rigid-fix and PINN-ACL Cross Pin for femoral side fixation. MATERIALS AND METHODS: 127 patients who underwent arthroscopic ACL reconstruction using autologous hamstring tendon and had been followedup for over than one year were enrolled for the present study. Rigid-fix was used in 71 cases (group 1), and PINN-ACL Cross Pin was used in 56 cases (group 2). Clinical and radiological results, operation time, and perioperative complications were compared amongst the two groups. RESULTS: The International Knee Documentation Committee subjective score and Lysholm score were 94 and 95 in group 1 and 87 and 91 in group 2, with no statistical difference (p=0.892, p=0.833), respectively. However, significant difference was observed in one-leg hop test between the two groups (p=0.032). Five cases in group 1 and 40 cases in group 2 were found to be associated with perioperative complications with statistical difference (p<0.0001). CONCLUSIONS: There was no resultant difference between the employment of PINN-ACL Cross Pin and Rigid-fix as femoral graft fixation for ACL reconstruction with hamstring tendon. However, PINN-ACL Cross Pin led to complications with extensive operation times. Hence, it needs further improvement of tools for minimization of complications.