Dataset Information

Effect of Different Screw Materials on ACL Reconstruction With the Tape Locking Screw Technique: A Retrospective Study From the FAST Cohort.

ABSTRACT:

Background

Screws for graft fixation are available in 3 different materials for anterior cruciate ligament reconstruction (ACLR) with the Tape Locking Screw (TLS) technique: titanium, poly-l-lactic acid bioabsorbable, and polyetheretherketone (PEEK).

Purpose

To compare the effect of the 3 different fixation materials on graft and implant survival after ACLR with the TLS technique.

Study design

Cohort study; Level of evidence, 3.

Methods

Included were 521 patients from the French Prospective ACL Study (FAST) cohort who underwent primary surgical ACLR with the TLS technique. Patients were divided into 3 groups depending on the type of screw material used: titanium (TLS-T group), poly-l-lactic acid bioabsorbable (TLS-B group), or PEEK (TLS-P group). The primary endpoint was a retear within 2 years after ACLR. The secondary endpoints were complication rate, return to sports rate, and functional scores. Objective and subjective functional scores-including the International Knee Documentation Committee, the Knee injury and Osteoarthritis Outcome Score (KOOS), and the Lysholm score-were evaluated preoperatively and at the 2-year follow-up. Pain was assessed with the KOOS-Pain subscore recorded pre- and postoperatively every 6 months up to 2 years. Patient satisfaction was recorded at the 2-year follow-up.

Results

No significant differences between the study groups were found in retear rates (4.4%, 4.5%, and 4.3% in the TLS-T, TLS-P, and TLS-B groups 2 years after surgery) or subjective and objective outcomes. The TLS-T group had the lowest rate of intraoperative implant-related complications (0.9%) compared with the TLS-P (4.3%) and TLS-B (7.7%) groups. Young age was a significant risk factor for retear in the TLS-T (P = .03) and TLS-B (P = .0001) groups, while a high level of sports was found to be a significant risk factor in the TLS-P (P = .04) group. All functional scores improved significantly at the 2-year follow-up (P < .0001), with no significant group difference. The KOOS-Pain subscore improved continuously with no significant group difference. The rate of return to preinjury sports was between 43.4% and 58.6%. The rate of highly satisfied patients at the final follow-up was between 86.2% and 91.8%.

Conclusion

There was no difference in retear rate or objective and subjective functional scores between implant materials for TLS ACLR in this study.

SUBMITTER: Sezer HB

PROVIDER: S-EPMC11329977 | biostudies-literature | 2024 Aug

REPOSITORIES: biostudies-literature

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Publications

Effect of Different Screw Materials on ACL Reconstruction With the Tape Locking Screw Technique: A Retrospective Study From the FAST Cohort.

Sezer Hasan Basri HB Bohu Yoann Y Hardy Alexandre A Coughlan Adam A Lefevre Nicolas N

Orthopaedic journal of sports medicine 20240816 8

<h4>Background</h4>Screws for graft fixation are available in 3 different materials for anterior cruciate ligament reconstruction (ACLR) with the Tape Locking Screw (TLS) technique: titanium, poly-l-lactic acid bioabsorbable, and polyetheretherketone (PEEK).<h4>Purpose</h4>To compare the effect of the 3 different fixation materials on graft and implant survival after ACLR with the TLS technique.<h4>Study design</h4>Cohort study; Level of evidence, 3.<h4>Methods</h4>Included were 521 patients fro ...[more]

PMID: 39157024

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Project description:PurposeOpen or fenestrated interference screw design that allow bone ingrowth is a concept for improved bone healing to softtissue graft and bone filling in bone tunnels after anterior cruciate ligament reconstruction (ACLR) The aim of the current study was to assess CT scanning evaluated bone ingrowth into an open architecture interference screws in the tibial tunnel of patients undergoing ACL with soft tissue grafts. It was hypothesized that open architecture interference screws would stimulate bone ingrowth into the screw cavities.MethodsTwelve patients requiring ACLR were included. They underwent arthroscopic ACLR with semitendinosus-/gracilis tendon graft and an open architecture polyetheretherketone (PEEK) interference screw. The patients were scanned with a multi-slice CT scanner two weeks, six and twelve months postoperatively. On CT reconstruction slices bone ingrowth into the screw was measured. Subjective and objective clinical outcome international knee documentation committee score and instrumented knee laxity determination were collected.ResultsAt six months no implants demonstrated more than 10% bone ingrowth. At twelve months 42% (5/12) implants had more than 10% bone ingrowth (p = 0.009). The average bone filling into the screws was 7.7%. There was no tunnel widening or cyst formation seen in relation to any of the implants. Subjective IKDC score improved significantly from 50.6 baseline to 80.1 at 24 month follow-up. Preoperative side-to-side knee laxity improved from 3.7 (2.1) to 1.4 (1.2) mm at twelve months. There were no serious adverse events in relation to the new open architecture thread PEEK interference screw during or after hamstring ACL reconstruction.ConclusionThe present study demonstrated that open architecture thread PEEK interference screw can stimulate bone ingrowth into the screws after soft tissue ACL reconstruction with at 12 months with an average bone filling into screws was 7.7%. Knee stability, functional, subjective and objective outcomes were similar to large volume ACL outcome studies.Trial registrationThe study was registered at ClinicalTrials # NCT02382341 . 12-09-2014.Level of evidenceIV.

Project description:BackgroundDifferent fixation methods in anterior cruciate ligament reconstruction (ACLR) have been associated with different revision rates, specifically in the early postoperative period. However, most previous research has either grouped together different fixation types or evaluated femoral-sided fixation or tibial-sided fixation separately. Therefore, the purpose of this study was to determine ACL revision rates for specific combinations of femoral and tibial fixation methods within 2 years of primary hamstring tendon autograft ACLR based on data from the Swedish National Knee Ligament Registry (SNKLR).MethodsPatients that underwent primary hamstring tendon autograft ACLR between 2005 and 2018 in the SNKLR were included. The collected data included patient characteristics (age, sex, body mass index [BMI]), activity at time of injury, surgical information (concomitant injuries, time from injury to surgery, fixation types at the femur and tibia), and subsequent revision ACLR. Revision rate within 2 years of the index procedure was chosen, as ACLR fixation is most likely to contribute to ACLR revision within the first 2 years, during graft maturation.ResultsOf the 23,238 included patients undergoing primary hamstring ACLR, 581 (2.5%) underwent revision ACLR within 2 years of the index procedure. Among the combinations used for > 300 patients, the femoral metal interference screw/tibial metal interference screw fixation combination had the highest revision rate followed by metal interference screw/resorbable screw and Endobutton/AO screw fixation combinations, with respective revision rates of 4.0, 3.0, and 3.0%. The lowest revision rate within 2 years of ACLR was found in the Endobutton/metal interference screw with backup Osteosuture fixation combination, used in 433 cases, with a failure rate of 0.9%.ConclusionDifferent early ACL revision rates were found across different combinations of femoral and tibial fixation devices within 2 years of primary hamstring tendon autograft ACLR. Metal interference screw fixation, particularly when performed on both the femoral and tibial sides, most frequently resulted in revision ACLR. These findings may be helpful for surgeons in selecting appropriate fixation devices for hamstring ACLR.Level of evidenceIV.

Project description:BackgroundIndependent transtibial pullout repair is a common surgical technique for repairing lateral meniscus posterior root tears (LMPRTs). The shared anterior cruciate ligament (ACL) bone tunnel technique is an alternative technique for LMPRT repair combined with ACL reconstruction (ACLR) to avoid the establishment of additional bone tunnels.PurposeTo compare the clinical outcomes of the shared ACL bone tunnel versus the independent transtibial pullout techniques for LMPRT repair combined with ACLR.Study designCohort study; Level of evidence, 3.MethodsBetween March 2014 and February 2018, a total of 48 patients were diagnosed with ACL injury with concomitant LMPRT; 22 patients underwent independent transtibial pullout repair (group T), and 26 patients underwent the shared ACL bone tunnel technique (group S). At a follow-up of >2 years, we compared knee functional recovery using the Lysholm, Tegner, and International Knee Documentation Committee scores and the pivot-shift test. Lateral meniscal extrusion, and cartilage degeneration on magnetic resonance imaging (MRI) scans were also compared. The healing status of the lateral meniscus posterior root was compared using second-look arthroscopy and MRI.ResultsThe duration of surgery was significantly shorter in group S compared with group T (98.3 ± 11.1 vs 127.9 ± 17.5 min; P = .001). At final follow-up, there were no significant differences between the 2 groups in knee functional scores, pivot shift, or grade of cartilage degeneration. Lateral meniscal extrusion was decreased in group S compared with group T (2.41 ± 0.61 vs 1.59 ± 1.35 mm; P = .014). Second-look arthroscopy revealed stable healing in 16 of 18 patients (88.9%) in group S and 10 of 15 patients (66.7%) in group T (P = .38).ConclusionBoth the shared ACL bone tunnel and the independent transtibial pullout techniques led to satisfactory clinical outcomes. The shared ACL bone tunnel technique is the simpler of the 2 procedures for combined LMPRT repair with ACLR.

Project description:PurposeThe objective of this study was to correlate the data of the 6-month postoperative isokinetic muscle evaluation before resuming sports activities with the occurrence of ACL reconstruction rerupture after semitendinosus short graft.MethodsFrom 2015 to 2018, all patients who were operated for an ACL reconstruction with a short semitendinosus autograft (TLS System) and who performed isokinetic tests on dynamometer at their 6th postoperative month were included in this study. The follow-up was prospective with the measurement of epidemiological, radiographic, and isokinetic parameters at 6 months of the ACL reconstruction. The cohort was divided into 2 groups: one group without an ACL reconstruction rerupture (Group 1) and the second group with a rerupture (Group 2).ResultsOne hundred and four patients were analyzed with an average follow-up of 42.3 months (Minimum: 24; Maximum: 63.5), of which 11 patients (10.6%) had an ACL reconstruction rerupture. Group 1 consisted of 93 patients with an average age of 26.5 ± 9.0 years old who did not have an ACL reconstruction rerupture with an average follow-up of 41.6 ± 12.1 months. Group 2 consisted of 11 patients with an average age of 22.7 ± 6.1 years old, who had an ACL reconstruction rerupture with an average follow-up of 44.8 ± 11.3 months. Concerning extension force recovery, the ratio between operated and healthy knee was 81.8% ± 32.0 for Group 1, and 53.4% ± 20.6 for Group 2 (P = .035). A statistically significant difference was also found (P = .0017) during 60°/s flexion isokinetic test between the two groups.ConclusionsThis study revealed a significant link between muscle weakness in flexion and extension during 60°/s isokinetic test at 6 months of ACL reconstruction and semitendinosus autograft rerupture. Patients with an ACL reconstruction retear had inferior muscle dynamometric recovery results at 6 months before resuming sports activities.Level of evidenceLevel III, prognostic, retrospective cohort study.

Dataset Information

Effect of Different Screw Materials on ACL Reconstruction With the Tape Locking Screw Technique: A Retrospective Study From the FAST Cohort.

Background

Purpose

Study design

Methods

Results

Conclusion

Publications

Effect of Different Screw Materials on ACL Reconstruction With the Tape Locking Screw Technique: A Retrospective Study From the FAST Cohort.

Similar Datasets

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