Abstract
Introduction Transcondylar fixation has recently been offered as an alternative method of femoral fixation in soft tissue ACL reconstructions. It provides the advantages of avoiding intra-articular hardware and of achieving full circumferential contact of soft tissue to bone for graft integration. This paper presents a series of hamstring ACL reconstructions using femoral transcondylar fixation in a short-term retrospective clinical review.
Methods Over a six month period the senior author performed a total of 50 hamstring anterior cruciate ligament reconstruction procedures using the femoral transcondylar fixation, 80% of these patients were available for review. The patient series consisted of 24 males and 16 females with average age of 29.9 years (range 14.4 to 54.5) at the time of surgery. Patients were assessed by clinical review, questionnaires (Lysholm and IKDC) and KT 1000 measurement at 30 lbs. Follow-up ranged from 12 to 16 months post-operatively with an average of 13.3 months.
Results The Lysholm scores mean was 83.9, which graded 75% of patients as good or excellent. Of the remaining patients 15% were fair and 10% graded their knee as poor. This was different from the IKDC patient questionnaire (subjective assessment) where 59% of patients categorised their knee as good or excellent. There were 70% of patients who rated their result poor or fair with respect to pain, and 52% of patients who rated their result poor or fair with respect to swelling. However, 67% of patients rated their knee good or excellent with respect to stability and function. Clinical laxity testing demonstrated a mean increase in translation of two millimetres (−3.3 to 5.3) in the index knee as compared to the opposite knee. On objective clinical tests, 97% of patients were normal or nearly normal with four percent being abnormal due to a passive motion deficit. There were no complications within the group and specifically no complications related to the transfix implant. No patient had pain, tenderness or crepitus around the iliotibial band.
Conclusions The femoral transcondylar fixation used in soft tissue ACL reconstructions is a viable alternative to interference screw fixation. It delivers comparable results in the short term, and offers potential advantages. The technique is reliable, reproducible and safe, with no complications being reported in this study.
The abstracts were prepared by Mr Jerzy Sikorski. Correspondence should be addressed to him at the Australian Orthopaedic Association, Ground Floor, William Bland Centre, 229 Macquarie Street, Sydney NSW 2000, Australia.
None of the authors have received any payment or consideration from any source for the conduct of this study.
