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, Prof., Seoul KOREA, REPUBLIC OF
In Jun Koh, MD, PhD, Prof., Seoul KOREA, REPUBLIC OF
Man-Soo Kim, MD, PhD, 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.