NDLI: Comparison of two different types of hybrid Tibial fixations for anterior cruciate ligament reconstruction: a prospective comparative cohort study

Content Provider	Springer Nature : BioMed Central
Author	Lai, Po-Jen Wong, Chin-Chean Chang, Wen-Pei Liaw, Chen-Kun Chen, Chih-Hwa Weng, Pei-Wei
Abstract	Background Previous studies have compared different kinds of fixations for anterior cruciate ligament reconstruction. Nevertheless, there is no optimal method to date. To the best of authors’ knowledge, there is no article discussing the combination of adjustable suspensory device and interference screw for hybrid tibial fixation. Methods In total, 66 patients (n = 34, adjustable suspensory device and interference screw; n = 32, cortical screw and interference screw) were analyzed. Their International Knee Documentation Committee score and Tegner activity level scale were evaluated before and after a 2-year follow-up. The Single Assessment Numeric Evaluation score was evaluated after a 2-year follow-up. Physical exams such as range of motion, anterior knee pain (VAS > = 3) and Lachman test were assessed before and at least 12 months after surgery. To evaluate tunnel widening, anteroposterior and lateral view radiography was conducted 1 day and at least 12 months after surgery. A more than 10% change was considered tibial tunnel widening. Mann–Whitney U test, independent t test, paired t test, Fisher’s exact test and chi-squared test were used to compare the variables. Linear and logistic regression models were applied to adjust for potential confounders. Results No variable except gender (P = 0.006) showed significant difference with regard to demographic data. After adjustment, there was no statistically significant difference between the groups regarding post-operative physical exams. Patients who used adjustable suspensory device and interference screw had lower post-operative Single Assessment Numeric Evaluation score (adjusted β − 8.194; P = 0.017), Tegner activity level scale (adjusted β − 1.295; P = 0.001) and pre-operative degrees of knee flexion (adjusted β − 2.825; P = 0.026). Less percentage of tunnel widening in the lateral view of radiographs was seen in patients in group of adjustable suspensory device and interference screw (adjusted β − 1.733; P = 0.038). No significant difference was observed in the anteroposterior view of radiographs (adjusted β − 0.667; P = 0.26). Conclusion In these 66 patients, we observed less tibial tunnel widening and lower post-operative functional scores in the group of adjustable suspensory device and interference screw. Both groups displayed similar outcomes of physical exams as well as improvement after operation. The proposed method may become an alternative option. Nonetheless, the quality of our study is still limited, and thus further studies are warranted to determine the efficacy and further application. Trial registration Joint Institutional Review Board of Taipei Medical University, Taipei, Taiwan (No: N201805094 ). Study design Prospective comparative cohort study; Level of evidence, II.
Related Links	https://bmcmusculoskeletdisord.biomedcentral.com/counter/pdf/10.1186/s12891-022-06057-3.pdf
Ending Page	13
Page Count	13
Starting Page	1
File Format	HTM / HTML
ISSN	14712474
DOI	10.1186/s12891-022-06057-3
Journal	BMC Musculoskeletal Disorders
Issue Number	1
Volume Number	23
Language	English
Publisher	BioMed Central
Publisher Date	2022-12-14
Access Restriction	Open
Subject Keyword	Orthopedics Rehabilitation Rheumatology Sports Medicine Internal Medicine Epidemiology Anterior cruciate ligament reconstruction Tunnel widening Tunnel enlargement Hamstring graft Hybrid fixation Adjustable suspensory device
Content Type	Text
Resource Type	Article
Subject	Orthopedics and Sports Medicine Rheumatology
Journal Impact Factor	2.2/2023
5-Year Journal Impact Factor	2.6/2023

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