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

Yıl 2012, Cilt: 3 Sayı: 1, 7 - 12, 01.03.2012

Mehmet Bulut Murat Gürger

https://doi.org/10.5799/ahinjs.01.2012.01.0102

Öz

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

Anahtar Kelimeler

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

Kaynakça

• Frank CB, Jackson DW. The science of reconstruction of the anterior cruciate ligament. J Bone Joint Surg Am 1997;79(10):1556-76.
• Hugston JC. Anterior cruciate deficent knee. Am J Sports Med 1983;11(1):1-2.
• Johnson RJ, Beynnon BD, Nichols CE, Renstrom PAFH. Current concepts review the treatment of in- juries of the anterior cruciate ligament. J Bone Joint Surg 1992;74(A):140-51.
• Keskin D, Ezirmik N, Karsan O, Okur A, Mert G. Kemik- patellar tendon-kemik otogreftleri ile ön çapraz bağ rekonstrüksiyonu sonuçları. AÜTD 2000;32:53-7.
• Price R, Stoney J, Brown G. Prospective randomized comparison of endobutton versus cross-pin femoral fixation in hamstring anterior cruciate ligament re- construction with 2-year follow-up. ANZ J Surg 2010, 80(3):162-5.
• Gorschewsky O, Klakow A, Riechert K, Pitzl M, Becker R. Clinical comparison of the Tutoplast allograft and outologous patellar tendon (bone-patellar tendon- bone) for the reconstruction of the anterior cruciate ligament: 2- and 6-year results. Am J Sports Med 2005;33(12):1202-9.
• Hong C, Jun H, Chang LB, Kim, Chul D, Hyun YJ. Histologic findings of anterior cruciate ligament re- construction with achilles allograft. Clin Orthopaedics &Related Res 2004;421(2):273-76.
• Harner CD, Olson E, Irrgang, James J. Allograft versus autograft anterior cruciate ligament reconstruction: 3 to 5 year outcome. Clin Orthopaedics & Related Res 1996;324(1):134-44.
• Indelli P, Francesco P , Michael F , Gary S. Ante- rior cruciate ligament reconstruction using cryopre- served allografts. Clin Orthopaedics & Related Res 2004;420(2):268-75.
• Plancher KD , Rıchard JS, Briggs KK. Reconstruc- tion of the anterior cruciate ligament in patients who are at least forty years old. a long-term follow-up and outcome study. J Bone Joint Surg Am 1998;80(1):184 -97.
• Moholkar K, Taylor D, O’Reagan M, Fenelon G. A Biomechanical analysis of four different methods of harvesting bone-patellar tendon-bone graft in porcine knees. J Bone Joint Surg Am 2002; 84(11):1782-7.
• Harter RA, Osterning LR, Singer KM. Long term eval- uation of knee stability and function following surgical reconstruction for anterior cruciate ligament insuffi- ciency. Am J Sports Med 1998;16(3):434-40.
• Hoffmann RFG, Peine R, Bail HJ, Südkamp NP, Weiler A. Initial Fixation Strenght of Modified Patellar Tendon Grafts for Anatomic Fixation in Anterior Cruciate Liga- ment Reconstruction. Arthroscopy 1999;15(2):392-9.
• Graham SM, Parker RD. Anterior Cruciate Ligament Reconstruction Using Hamstring Tendon Grafts. Clin Orthopaedics & Related Res 2002;402(1):64-75.
• Kurt PS, Todd AW, Callison JC, Secic M, Sheryl B. Clinical outcome at a minimum of five years after re- construction of the anterior cruciate ligament. J Bone Joint Sur. 2005;87(10):1673-9.
• Hamada M, Shino K,Mitsuka T,Abe N, Horibe S. Cross-Sectional area measurement of the semiten- dinosus tendon for anterior cruciate ligament recon- struction. Arthroscopy 1998;14(5);696-701.
• Falconiero RP, Di Stefano VJ, Cokk TM. Revascu- larization and ligamentization of autogenous ante- rior cruciate ligament graft in humans. Arthroscopy 1998;14(2):197-205.
• Gillquist J. Odensten M. Artrhroscopic reconstruc- tion of the anterior cruciate ligament. Arthroscopy 1996;4(1):5-9.
• Howell G, Wertheimer C, Johnson RJ, et al. Artrhro- scopic strain gauge measurement of the anterior cru- ciate ligament. Arthroscopy 2000;6(2):198-204.
• Eriksson K, Anderberg P, Hamberg P, et al. A Com- parision of quadruple semitendinosus and patellar tendon graft in reconstruction of the anterior cruciate ligament. J Bone Joint Surg 2001;83(B):622-40.
• Williams RJ, Hyman J, Petrigliano F. Anterior cru- ciate ligament reconstruction with a four-strand hamstring tendon autograft. J Bone Joint Surg Am 2004;86(2):225-32.
• Yasuda K, Tsujino J, Ohkoshi Y, Tanabe Y, Kaneda K. Graft site morbidity with autogenous semiten- dinosus and grasilis tendons. Am J Sports Med 1995;23(5):706-14.
• Brand J Jr, Weiler A, Caborn DN, Brown CH Jr, John- son DL. Graft fixation in cruciate ligament reconstruc- tion. Am J Sports Med 2000;28(6):761-74.
• Monaco E, Labianca L, Speranza A , et al. Biome- chanical evaluation of different anterior cruciate liga- ment fixation techniques for hamstring graft. J Orthop Sci 2010;15(1):125-31.
• Shen HC, Chang JH, Lee CH, et al. Biomechanical comparison of Cross-pin and Endobutton-CL femoral fixation of a flexor tendon graft for anterior cruciate ligament reconstruction-a porcine femurgraft-tibia complex study. J Surg Res 2010;15(2):282-87.
• Yosmaoğlu HB, Baltacı G, Kaya D, Ozer H, Atay A. Comparison of functional outcomes of two ante- rior cruciate ligament reconstruction methods with hamstring tendon graft. Acta Orthop Traumatol Turc 2011;45(4):240-7.
• Ahmad CS, Gardner TR, Groh M, Arnouk J, Levine WN. Mechanical properties of soft tissue femoral fixa- tion devices for anterior cruciate ligament reconstruc- tion. Am J Sports Med 2004; 32(5): 635-40.
• Harilainen A, Sandelin J, Jansson KA. Cross-pin femoral fixation versus metal interference screw fixa- tion in anterior cruciate ligament reconstruction with hamstring tendons: results of a controlled prospective randomised study with 2 year follow-up. Arthroscopy 2005;21(1):23-33.