Abstract
A new fixating device was developed for fixation of the anterior cruciate ligament using hamstrings and allowing immediate full weight bearing and full range of movements as pain subsides. The surgical technique is simple, similar to the one described by L. Johnson: a femoral tunnel of 25 mm depth without exit on the lateral wall of the femur. The tibial tunnel is drilled in the usual manner. In order to achieve a straight line drill of the tibia and the femur an aimer is used. The hamstrings are harvested in the usual manner and used as free graft.
The new anchor is composed of 2 parts: a self tapping screw and an oval eyelet.
The harvested hamstrings are passed through the eyelet and doubled. The assembled system is passed through the tibia directly into the femur and screwed in place. For distal fixation 2 square staples are used.
The patients are discharged on the same operative day, and followed.
On follow up the clinical exam included assessment of range of movements, stability (Lachman, Pivot shift). The results of a subjective rating of patients’ satisfaction was also taken into consideration.
The anchor was used in 50 cases: 46 males and 4 females. In 4 cases semitendinosus alone was used as graft. Full range of movements and weight bearing were allowed as pain subsided. Short term follow-up (3 years) showed excellent results. No complication of any type (infection, loosening or vascular) were encountered. 48 of the 50 cases returned to their previous activity without any limitation. However, in 2 cases meniscal tears occurred:
1 medial meniscus and 1 lateral meniscus and were considered as failures because the stability achieved was insufficient for their activity. It has to be pointed out that none of our patients were professional athletes.
The abstracts were prepared by Orah Naor. Correspondence should be addressed to him at the Israel Orthopaedic Association, PO Box 7845, Haifa 31074, Israel.
