Clinical comparison of cross-pin and EndoButton for fixation of hamstring grafts

Abstract

Objectives: A comparison of the clinical outcomes of EndoButton and cross-pin femoral fixation techniques in anterior cruciate ligament (ACL) reconstruction using hamstring tendons. Materials and methods: In our clinic, between January 2006 and December 2009 patients who underwent surgery due to ACL rupture were retrospectively reviewed. Of the patients, 50 underwent arthroscopic anterior cruciate ligament reconstruction with an autogenous hamstring tendon graft using the cross-pin technique, and the remaining 50 patients underwent arthroscopic anterior cruciate ligament reconstruction with the EndoButton technique. Preoperative and postoperative clinical evaluation of the patients in both groups was performed according to the International Knee Documentation Committee (IKDC) and Lysholm II knee scoring systems. Results: In the cross-pin group, 52% of the patients had IKDC scores of A, 40% B and 8% C in the last control. In the EndoButton group, 48% of the patients had IKDC scores of A, 42% B and 10% C. Postoperatively, 48% of the patients in the cross-pin group had excellent, 44% good and 8% fair Lysholm scores. Fifty percent of the patients in the EndoButton group had excellent, 44% good and 6% fair Lysholm scores. There was no difference between the groups in additional diseases, IKDC and Lysholm scores and complications. The mean operative time was shorter in the EndoButton group. Conclusions: No statistically significant difference was found between the clinical outcomes of the femoral fixation techniques. The shorter operative time and easier learning curve are advantages of the EndoButton technique in ACL reconstruction. J Clin Exp Invest 2012; 3(1): 7-12

Keywords

• Anterior cruciate ligament, hamstring tendon graft, femoral fixation

Ön çapraz bağ rekonstrüksiyonunda cross-pin ve EndoButton ile yapılan hemstring greft fiksasyonunun klinik karşılaştırılması

Öz

Amaç: Hamstring tendonları kullanılarak yapılan ön çapraz bağ (ÖÇB) rekonstrüksiyonlarında EndoButton ve cross-pin femoral tespit yöntemlerinin klinik sonuçlarının karşılaştırılması. Hastalar ve yöntem: Kliniğimizde Ocak 2006 - Aralık 2009 tarihleri arasında ÖÇB rüptürü nedeniyle opere edilen hastalar geriye dönük olarak incelendi. Hastaların 50 tanesine cross-pin, 50 tanesine ise EndoButton yöntemi kullanılarak, otojen hamstring tendon grefti ile artroskopik ön çapraz bağ rekonstrüksiyonu yapılmıştı. Her iki grupta hastaların ameliyat öncesi ve sonrası klinik değerlendirmesi uluslararası diz dökümantasyon sistemi (IKDC) ve Lysholm II skorlama sistemine göre yapıldı. Sonuçlar: Ameliyat sonrası cross-pin grubunda IKDC skorlama sistemine göre hastaların, %52’sinde A, %40’ında B, %8’inde C skoru bulundu. EndoButton grubunda hastaların %48’inde A, %42’sinde B, %10’unda C skoru bulundu. Ameliyat sonrası cross-pin grubunda Lysholm II skorlama sistemine göre hastaların %48’inde mükemmel, %44’ünde iyi ve %8’inde orta sonuç bulundu. EndoButton grubunda hastaların %50’sinde mükemmel, %44’ünde iyi, %6’sında orta sonuç bulundu. Gruplar arasında ek hastalık, IKDC ve Lysholm II skorları ve komplikasyonlar açısından fark yoktu. EndoButton grubunda ortalama ameliyat süresi daha kısaydı. Sonuç: Her iki femoral tespit tekniğinin, klinik sonuçları arasında istatistiksel olarak anlamlı fark bulunmadı. Ameliyat süresinin daha kısa, öğrenme eğrisinin daha kolay oluşu ÖÇB rekonstrüksiyonunda EndoButton tekniğinin avantajlarıdır.

Anahtar Kelimeler

• Ön çapraz bağ, hamstring tendon grefti, femoral tespit

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