Abstract
Background: Female patients undergoing arthroscopic anterior cruciate ligament reconstruction with a hamstring tendon graft developed increased postoperative laxity compared to male and female patients who had reconstruction using a patellar tendon graft. This difference may be due to graft slippage in less dense female tibial bone.
Hypothesis: Reinforcement of tibial fixation of the hamstring tendon graft in women by supplementary methods may reduce laxity.
Study Design: Randomized controlled clinical trial; Level of evidence, 2.
Methods: Fifty-six female patients divided into 2 groups (standard tibial fixation with 7 · 25–mm metal interference screw versus metal interference screw with supplementary staple fixation) were followed for 2 years.
Results: After 2 years, the mean side-to-side difference using KT-1000 arthrometer manual maximum measurements was 1.8 mm (standard group) and 1.1 mm (staple group) (P = .05). The percentage of patients with a side-to-side difference of < 3 mm did not differ significantly between the 2 groups (P = .66): 88.8% of the standard group versus 90.5% of the staple group. A grade 0 Lachman test result was present in 63% of the standard group and 86% of the staple group (P = .04). Kneeling pain was experienced by 7% of the standard group and 29% of the staple group (P = .05).
Conclusions: Supplementary tibial fixation in female patients undergoing anterior cruciate ligament reconstruction with hamstring tendon graft in addition to a single-size screw significantly improves laxity measurements and clinical stability assessment 2 years after surgery. However, this improvement is at the cost of increased kneeling pain.
Get full access to this article
View all access options for this article.