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clinmed/2000010002v1 (January 10, 2000)
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Transcondylar screw fixation in ACL reconstruction

Pier P Mariani, Gianluca Camillieri, Fabrizio Margheritini, Ezio Adriani, and Gaetano Maresca

Orthopaedic Department University La Sapienza Rome, Laboratory of Arthroscopic and Joint Surgery

Summary: Two different methods of femoral fixation for arthroscopically-assisted ACL reconstruction were evaluated at 2 years follow-up: Group A (24 patients), B-PT-B reconstruction with intrarticular screw fixation; and Group B (31 patients), B-PT-B reconstruction with transcondylar screw fixation. Patients were evaluated with the IKDC form, Lysholm-II form, Tegner scoring system, and KT-2000 arthrometer. In group A, final IKDC clinical evaluation revealed 0% grade A, 62.5% grade B, 25% grade C, and 12.5% grade D. In group B, 29.1% achieved grade A, 54.8% grade B, 12.9% grade C, and 3.2% grade D. The difference was statistically significant (P<0.05). The I-N side-to-side KT-2000 difference at maximum manual loading was 3.68 mm (SD 1.71) in group A and 1.64 (SD 2.05) in group B with P<0.0001. In conclusion, objective differences in outcome between the two methods of fixation were detected and the better results achieved with transcondylar procedure may be attributed to the type of fixation that was the only differing step between the two procedures. Transcondylar fixation offers the following advantages: fixation without intra-articular hardware, greater bone-to-bone fixation, and possibility of fixation with breakage of the posterior femoral tunnel wall. Moreover, this method may be useful in revisional ACL surgery. Key Words: ACL reconstruction-Fixation-Knee-Arthroscopy