ISAKOS: 2019 Congress in Cancun, Mexico
ISAKOS

2019 ISAKOS Biennial Congress ePoster #767

 

Does Cortical Non-Contact or Delayed Contact of an Adjustable-Loop Femoral Button Affect Knee Stability After Anterior Cruciate Ligament Reconstruction?

Chulkyu Kim, MD, Seoul KOREA, REPUBLIC OF
Sueen Sohn, MD, Seoul KOREA, REPUBLIC OF
In-Jun Koh, MD, PhD, Prof., Seoul KOREA, REPUBLIC OF
Man-Soo Kim, MD, Seoul KOREA, REPUBLIC OF
Kwang-Yun Song, MD, Incheon KOREA, REPUBLIC OF
Yong In, MD, PhD, Seoul KOREA, REPUBLIC OF

Seoul St. Mary’s Hospital, The Catholic University of Korea , Seoul, KOREA, REPUBLIC OF

FDA Status Cleared

Summary

Neither cortical non-contact nor delayed contact of the adjustable-loop femoral button affected knee stability and clinical outcomes after ACL reconstruction.

Abstract

Purpose

Adjustable-loop cortical suspensory device has higher risk of soft tissue interposition between femoral cortex and the button. Soft tissue interposition, known as a probable risk factor for failure of the graft, can be identified when the button is found non-contact state in postoperative radiographs. However, in a single-bundle reconstruction which is more vulnerable to the fixation strength than double-bundle technique, the effect of non-contact or delayed contact is not reported yet. The purpose of this study was to investigate whether cortical non-contact or delayed contact of the adjustable-length loop cortical button affects knee stability and clinical outcomes after anterior cruciate ligament (ACL) reconstruction.

Methods

Fifty seven patients who underwent autogenous hamstring ACL reconstruction with single-bundle technique using an adjustable-loop femoral cortical button were divided into two groups according to cortical contact or not. In immediate post-operative radiographs, 29 (51 %) showed femoral cortical contact of the button (Contact group), while 28 (49 %) showed cortical non-contact (Non-contact group). During 2-year follow-up period, cortical non-contact group was divided into two subgroups, 16 (57 %) whose button showed delayed contact to the femoral cortex (Delayed contact subgroup) and 12 (43 %) whose button showed persisting non-contact (Persisting non-contact subgroup). Knee stability and clinical outcomes were compared between groups and subgroups using KT-1000 arthrometer, Lysholm knee score, and International Knee Documentation Committee (IKDC) score.

Results

There were no significant differences in knee stability and clinical outcomes between Contact and Non-contact groups (KT-1000; 1.6 ± 0.9 mm and 1.4 ± 0.9 mm, respectively, p = 0.329) (Lysholm score; 94.1 ± 7.6 and 95.1 ± 6.0, respectively, p = 0.488) (IKDC score; 82.9 ± 12.5 and 85.5 ± 12.5, respectively, p = 0.463). In subgroup analysis within Non-contact group, no differences were found between Delayed contact and Persisting non-contact subgroups in the knee stability and the functional outcomes at 2 years postoperatively.

Conclusion

Neither cortical non-contact nor delayed contact of the adjustable-loop femoral button affected knee stability and clinical outcomes after ACL reconstruction.