Anterior cruciate ligament (ACL) injuries are one of the most common ligament injury occurring in young and active individuals. Reconstruction of the torn ligament is the current standard of care. Of the many factors which determine the surgical outcome, fixation of the graft in the bony tunnels has significant role. This study compared the clinical and functional outcome in patients who underwent ACL reconstruction by standard anteromedial portal technique with single bundle hamstring graft anchored in the femoral tunnel using rigidfix and cortical button with adjustable loops. The tibial fixation and rehabilitation protocol were same in both groups.

107 patients underwent ACL reconstruction over a two-year period (87 males, 20 females, 44 after motor vehicle accident, 34 after sports injuries, 79 isolated ACL tear, 21 associated medial meniscus tear, 16 lateral meniscus tear and 11 both menisci). Rigid fix group had 47 patients and adjustable loop 60 patients. Clinical evaluation at end of one year showed better stability in rigid fix group regarding Lachman, anterior drawer, pivot shift tests, KT 1000 arthrometer side to side difference and hop limb symmetry index. However, the differences were not statistically significant.

Functional evaluation using IKDC 2000 subjective score and Lysholm score showed better results in rigidfix group than variable loop, but was not statistically significant. However, lower scores were noted in patients with concomitant meniscal injury than in isolated acl tear patients and this was statistically significant in both groups.

Rigidfix seems to give better graft fixation on femoral side than variable loop, but by the end of one year the functional outcome is comparable in isolated acl reconstructions.

The use of massive endoprostheses following bone tumour resection is well recognised. Where possible, joint salvage rather than joint replacement is usually attempted. However cases arise where there may be insufficient bone stock following tumour resection to allow fixation of a joint sparing prosthesis. We report a series of 4 patients (age4–12) treated between 1994 and 2008, in which irradiated autologous bone has been combined with a diaphyseal or distal femoral replacement in order to preserve the native hip joint. There were 3 cases of osteosarcoma and 1 cases of Ewings sarcoma. After a mean follow up of 53 months (range 9–168) all patients had survived without evidence of local recurrence or metastases. One implant was revised after 14 years following fracture of the extending component of the growing endoprosthesis. There have been no cases of loosening or peri-prosthetic fracture. This is the first report of irradiated autologous bone with joint sparing endoprostheses in the skeletally immature patient.

Introduction: Reconstruction of segmental skeletal defects after malignant bone tumour removal has been a topic of much debate. Autoclaved or irradiated autologous bone used in the treatment of malignant bone tumours of the proximal femur in skeletally mature patients has been well reported with a high incidence of fracture and non-union. On follow up, our series of skeletally immature patients showed excellent osteo-integration with native bone and allowed preservation of the native hip joint.

Results: We review survival of the patient, implant, any complication and the presence of disease progression.

Introduction: Massive endoprostheses are widely employed in limb salvage surgery for malignant bone tumours. Whilst joint preservation rather than replacement is usually attempted, cases arise where there is insufficient bone following tumour resection to allow adequate fixation of a joint sparing prosthesis.

Method: We report a series of four patients (aged 4–12), in which irradiated autologous bone was combined with distal femoral replacement in order to preserve the native hip joint.

Results: There were three cases of Osteosarcoma and one Ewing’s sarcoma. After a mean follow-up of 53.5 months (range 9–168), all four patients are alive without evidence of local recurrence or metastases. One implant was revised after 14 years following fracture of the extending component of the growing endoprosthesis. There were no cases of loosening or peri-prosthetic fracture.

Discussion: This is the first report of a new technique utilising irradiated autologous proximal femoral bone combined with distal femoral replacement in skeletally immature patients.

The use of massive endoprostheses following bone tumour resection is well recognised. Where possible, joint salvage rather than joint replacement is usually attempted. However cases arise where there is insufficient bone following tumour resection to allow adequate fixation of a joint sparing prosthesis. We reporta series of 4 patients (aged 4–12), treated between 1994 and 2008, in which irradiated autologous bone has been combined with a diaphyseal or distal femoral replacement in order to preserve the native hip joint.

There were 3 cases of osteosarcoma and 1 case of Ewing‘s sarcoma. After a mean follow-up of 53.5 months (range 9–168), all four patients are alive without evidence of local recurrence or metastases. One implant was revised after 14 years following fracture of the extending component of the growing endoprosthesis. There have been no cases of loosening or periprosthetic fracture.

This is the first report of irradiated autologous bone with joint sparing endoprostheses in skeletally immature patients.