Introduction

The aim of this study was to investigate whether methylene blue dye, commonly used in sterile surgical marker pens, would have an effect on human chondrocyte viability, when cultured on a collagen membrane in-vitro.

Introduction: Double bundle anterior cruciate ligament (DBACL) reconstruction has been shown to improve objective measurements of rotational stability. However, subjective improvement in patient outcome has yet to be shown. The aim of this study was to investigate whether double bundle ACL reconstruction could provide satisfactory subjective and objective outcome in a consecutive patient series at a minimum of two years post operatively.

Methods: From May 2006 a consecutive group of patients underwent double bundle ACL reconstruction using doubled semitendinosus (anteromedial bundle) and gracilis (posterolateral bundle) tendons fixed with interference screws in both femur and tibia. Pre and post operative subjective and objective IKDC 2000 knee scores were collected including pivot shift and KT-1000 arthrometer assessments. A comparison was made to a cohort of single bundle ACL reconstructions performed by the same surgeon whose data was collected previously.

Results: The group included 29 patients (26 male, mean age 30; range 18–47). A significant improvement in subjective IKDC 2000 score between preop (54.8) and last follow up (76.3) was shown (p = 0.00); 96% of subjects were IKDC grade A or B; 85% of subjects had a negative pivot shift on last review with 15% eliciting a pivot glide. There were no differences in subjective or objective outcomes between the double bundle and single bundle groups.

Discussion: This data compares favourably with other published series of double bundle ACL reconstruction. Although subjective improvement in functional outcome is seen, early results do not show an improvement over single bundle reconstruction. It remains to be shown if this technique will confer an overall improvement in long term outcome via the more anatomical reconstruction.

The purpose of this study was to describe our experience of the Calaxo Osteoconductive interference screw (Smith & Nephew) when used for both femoral and tibial graft fixation in Double Bundle ACL reconstruction.

Since May 2006, all patients with an ACL deficient knee were reconstructed using the Double Bundle technique. All were followed prospectively and outcome data collected. Evidence of fixation failure was established subjectively by clinical examination (Lachman, Anterior Draw, Pivot Shift) and objectively via KT-1000 arthrometer. Following ethical approval, post-operative CT scans (immediate and 1 year) were performed on our first 10 patients allowing assessment of tunnel dimensions/fill.

Thirty two patients (29 male, 3 female) with a mean age of 30 (range 18-46) were included. At last follow-up, no evidence of graft/fixation failure was found; KT-1000 mean side-side difference 1.4mm (range −3 to +6). All patients had a positive pivot shift preoperatively which was abolished postoperatively. One patient had a postoperative infection with no other complications reported. Radiologically the screws did not show complete resorption but areas of new bone were identified.

We have shown satisfactory results with use of the Calaxo screw when used in Double Bundle Reconstruction. We have not had any cases of the adverse local soft tissue reaction, which has led to this screw being withdrawn from clinical use. Even when using a total of four screws in each knee. A previous study published by Seibold (2007) has shown tunnel widening and communication when suspensory fixation is used in Double Bundle reconstruction. This has the potential risk of leading to fracture between the tunnels. This has not been seen with the Calaxo screw which may be a result of the biological action of the screw which should ultimately lead to a reduction in these risks.

Introduction: The purpose of this study was to describe our experience of the Calaxo Osteoconductive interference screw (Smith & Nephew) when used for both femoral and tibial graft fixation in Double Bundle ACL reconstruction.

Methods: Since May 2006, all patients with an ACL deficient knee were reconstructed using the Double Bundle technique. All were followed prospectively and outcome data collected.

Evidence of fixation failure was established subjectively by clinical examination (Lachman, Anterior Draw, Pivot Shift) and objectively via KT-1000 arthrometer.

Following ethical approval, post-operative CT scans (immediate and 1 year) were performed on our first 10 patients allowing assessment of tunnel dimensions/fill.

Results: Thirty two patients (29 male, 3 female) with a mean age of 30 (range 18–46) were included. At last follow-up, no evidence of graft/fixation failure was found; KT-1000 mean side-side difference 1.4mm (range −3 to +6). All patients had a positive pivot shift preoperatively which was abolished postoperatively. One patient had a postoperative infection with no other complications reported. Radiologically the screws did not show complete resorption but areas of new bone were identified.

Discussion: We have shown satisfactory results with use of the Calaxo screw when used in Double Bundle Reconstruction. We have not had any cases of the adverse local soft tissue reaction, which has led to this screw being withdrawn from clinical use. Even when using a total of four screws in each knee.

A previous study published by Seibold (2007) has shown tunnel widening and communication when suspensory fixation is used in Double Bundle reconstruction. This has the potential risk of leading to fracture between the tunnels.

This has not been seen with the Calaxo screw which may be a result of the biological action of the screw which should ultimately lead to a reduction in these risks.