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J Knee Surg 2023; 36(10): 1069-1076
DOI: 10.1055/s-0042-1749396
Original Article

Comparative Results of Anterior Cruciate Ligament Reconstruction with Full Tibial Tunnel: Quadrupled Semitendinosus Suspensory Femoral and Tibial Fixation versus Quadrupled Semitendinosus and Gracilis Suspensory Femoral and Tibial Screw and Staple Fixation

Mahir Mahirogullari 
1   Department of Orthopaedics and Traumatology, Sisli Memorial Hospital, Istanbul, Turkey
,
Lokman Kehribar 
2   Department of Orthopaedics and Traumatology, Samsun Gazi State Hospital, Samsun, Turkey
,
Serkan Surucu 
3   Department of Orthopaedic Surgery, University of Missouri Kansas City, Kansas City, USA
,
Mahmut E. Kayaalp 
4   Department of Orthopaedics and Traumatology, Istanbul Taksim Training and Research Hospital, Istanbul, Turkey
,
Ali K. Yilmaz
5   Faculty of Yaşar Dogu Sport Sciences, Ondokuz Mayıs University, Samsun, Turkey
,
Mahmud Aydin 
6   Department of Orthopaedics and Traumatology, Haseki Training and Research Hospital, Sultangazi, İstanbul, Turkey
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Abstract

This study compared the clinical outcomes of patients treated with described “modified all-inside” anterior cruciate ligament reconstruction (ACLR) technique with those of patients treated with suspensory femoral fixation and a bioabsorbable tibial interference screw with the ACLR technique. From 2017 to 2019, 98 patients who underwent ACLR surgery by two surgeons using either of the techniques were included in this study. Patients in group 1 were treated with the “modified all-inside” ACLR technique. In this technique, only the semitendinosus tendon was harvested as a four-strand graft and fixed to the tibia and femur with suspensory buttons. Patients in group 2 were treated with suspensory femoral fixation and a bioabsorbable tibial interference screw ACL reconstruction technique. Patients' functional outcomes were evaluated by the Lysholm score, Tegner activity scale, and International Knee Documentation Committee (IKDC) subjective score. Postoperative knee stability of the patients was evaluated using the Lachman test and the pivot-shift test. The mean ages of the patients were 31.1 (16–55) and 28.7 (18–48) years in groups 1 and 2, respectively. The average follow-up durations were 26 (20–30) and 25.9 (22–30) months for both groups. There was no significant difference between the preoperative and postoperative Lysholm's score, Tegner's activity score, and IKDC subjective score in groups 1 and 2. There were no major complications or reruptures in either group. ACLR incorporating the “modified all-inside” ACLR technique obtained significant clinical outcomes compared to ACLR with a suspensory femoral fixation and a bioabsorbable tibial interference screw.

Keywords

anterior cruciate ligament reconstruction - cortical suspensory fixation - interference screw - ACL rupture


Publication History

Received: 17 April 2021

Accepted: 17 March 2022

Article published online:
12 July 2022

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