One- Year Serial Follow-up Magnetic Resonance Imaging Study of RigidFix for Femoral Fixation in Anterior Cruciate Ligament Reconstruction
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Purpose: To assess graft slippage at the site of femoral fixation by followup magnetic resonance imaging (MRI) after anterior cruciate ligament (ACL) reconstruction with a fourstrand autogenous hamstring tendon using RigidFix (DePuy Mitek).Materials and Methods: Twentyone 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. Followup 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 crosspin were assessed. Sidetoside 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. Crosspin 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 followup. 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. Crosspin breakage did not affect the clinical outcomes. Careful preparation of the graft is needed for performing the technique correctly.
Abstract
Purpose: To assess graft slippage at the site of femoral fixation by followup magnetic resonance imaging (MRI) after anterior cruciate ligament (ACL) reconstruction with a fourstrand autogenous hamstring tendon using RigidFix (DePuy Mitek).Materials and Methods: Twentyone 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. Followup 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 crosspin were assessed. Sidetoside 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. Crosspin 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 followup. 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. Crosspin breakage did not affect the clinical outcomes. Careful preparation of the graft is needed for performing the technique correctly.
참고문헌 (27)
- Middleton KK, "Anatomic anterior cruciate ligament(ACL)reconstruction : a global perspective : part 1", Knee Surg Sports Traumatol Arthrosc, 22, pp.1467~1482 (2014)
- Feller JA, "A randomized comparison of patellar tendon and hamstring tendon anterior cruciate ligament reconstruction", Am J Sports Med, 31, pp.564~573 (2003)
- Laxdal G, "A prospective randomized comparison of bone-patellar tendon-bone and hamstring grafts for anterior cruciate ligament reconstruction", Arthroscopy, 21, pp.34~42 (2005)
- Ibrahim SA, "Intratunnel versus extratunnel autologous hamstring double-bundle graft for anterior cruciate ligament reconstruction : a comparison of 2 femoral fixation procedures", Am J Sports Med, 43, pp.161~168 (2015)
- Choi NH, "Tibial tunnel widening after hamstring anterior cruciate ligament reconstructions : comparison between Rigidfix and Bio-TransFix", Knee, 20, pp.31~35 (2013)
- Lee YS, "Structural change of soft tissue anterior cruciate ligament reconstructions with cross-pin fixation between immediate and postoperative 8 weeks : a study with use of magnetic resonance imaging", Am J Sports Med, 37, pp.285~290 (2009)
- Ahmad CS, "Mechanical properties of soft tissue femoral fixation devices for anterior cruciate ligament reconstruction", Am J Sports Med, 32, pp.635~640 (2004)
- Yammine K, "Effect of partial medial meniscectomy on anterior tibial translation in stable knees : a prospective controlled study on 32 patients", BMC Sports Sci Med Rehabil, 5, pp.17~ (2013)
- Wieser K, "Experimental loss of menisci, cartilage and subchondral bone gradually increases anteroposterior knee laxity", Knee Surg Sports Traumatol Arthrosc, 20, pp.2104~2108 (2012)
- Jacobsen K, "Stress radiographical measurement of the anteroposterior, medial and lateral stability of the knee joint", Acta Orthop Scand, 47, pp.335~334 (1976)
- Jacobsen K., "Gonylaxometry. Stress radiographic measurement of passive stability in the knee joints of normal subjects and patients with ligament injuries: accuracy and range of application", Acta Orthop Scand Suppl, 194, pp.1~263 (1981)
- Shervegar S, "Functional outcome following arthroscopic ACL reconstruction with Rigid Fix : a retrospective observational study", Arch Bone Jt Surg, 3, pp.264~268 (2015)
- 서승석, "ACL Reconstruction with Autologous Hamstring Tendon: Comparison of Short Term Clinical Results between Rigid-fix and PINN-ACL Cross Pin", Knee Surgery and Related Research, 23(4), pp.208~212 (2011), 대한슬관절학회
- Singhatat W, "How four weeks of implantation affect the strength and stiffness of a tendon graft in a bone tunnel: a study of two fixation devices in an extraarticular model in ovine", Am J Sports Med, 30, pp.506~513 (2002)
- Zantop T, "Cyclic loading comparison between biodegradable interference screw fixation and biodegradable double cross-pin fixation of human bone-patellar tendon-bone grafts", Arthroscopy, 21, pp.934~941 (2005)
- Dargel J, "Comparison of initial fixation properties of sutured and nonsutured soft tissue anterior cruciate ligament grafts with femoral cross-pin fixation", Arthroscopy, 24, pp.96~105 (2008)
- Noyes FR, "Biomechanical analysis of human ligament grafts used in knee-ligament repairs and reconstructions", J Bone Joint Surg Am, 66, pp.344~352 (1984)
- Morrison JB, "The mechanics of the knee joint in relation to normal walking", J Biomech, 3, pp.51~61 (1970)
- Kousa P, "The fixation strength of six hamstring tendon graft fixation devices in anterior cruciate ligament reconstruction. Part II: tibial site", Am J Sports Med, 31, pp.182~188 (2003)
- Wu JL, "Mechanical comparison of biodegradable femoral fixation devices for hamstring tendon graft : a biomechanical study in a porcine model", Clin Biomech(Bristol, Avon), 24, pp.435~440 (2009)
- Rodeo SA, "Tendon-healing in a bone tunnel : a biomechanical and histological study in the dog", J Bone Joint Surg Am, 75, pp.1795~1803 (1993)
- Lee YS, "Comparative outcome analysis of malpositioned and properly positioned fixation groups after hamstring autograft ACL reconstruction with femoral cross-pin fixation", Knee, 18, pp.30~33 (2011)
- Ahn JH, "Femoral cross-pin breakage and its effects on the results of anterior cruciate ligament reconstruction using a hamstring autograft", Arthroscopy, 28, pp.1826~1832 (2012)
- Choi NH, "Do broken cross-pins compromise stability after anterior cruciate ligament reconstructions with hamstring tendons?", Arthroscopy, 23, pp.1334~1340 (2007)
- Studler U, "Anterior cruciate ligament reconstruction by using bioabsorbable femoral cross pins : MR imaging findings at follow-up and comparison with clinical findings", Radiology, 255, pp.108~116 (2010)
- Milano G, "Comparison between different femoral fixation devices for ACL reconstruction with doubled hamstring tendon graft : a biomechanical analysis", Arthroscopy, 22, pp.660~668 (2006)
- Hunt P, "Soft tissue graft interference fit fixation : observations on graft insertion site healing and tunnel remodeling 2 years after ACL reconstruction in sheep", Knee Surg Sports Traumatol Arthrosc, 14, pp.1245~1251 (2006)