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Volume 8 Issue 2 (February, 2020)

Original Articles

Comparison of functional outcome of arthroscopic ACL reconstruction between adjustable closed loop and endobutton for femoral fixation of quadrapuled hamstring autograft
Ajay Singh Thakur, Barun Datta, Ankur Deshwal, Chetan Sood

Background: Cortical suspension devices have been widely used in ACL reconstruction for femoral side graft fixation. Fixed-length and adjustable-length loop devices are two common suspensory loop devices that are used in ACL reconstruction. They both have their own biomechanical pros and cons. The purpose of this study is to determine the difference in functional outcome of anatomical single bundle ACL reconstruction using fixed length versus adjustable length loop in femoral fixation of quadrupled hamstring graft. Material and methods: It is a longitudinal prospective study conducted in _various military hospitals of Indian army. There were 60 patients enrolled in the study. The first 30 patients were treated with Arthroscopic ACL reconstruction with quadrupled hamstring graft from ipsilateral limb fixed with Endobutton on femoral side and bio-absorbable interference tibial screw, similarly in subsequent 30 patients ACL reconstruction were treated with quadrupled hamstring graft from ipsilateral limb fixed with closed adjustable loop on femoral side and bio-absorbable interference tibial screw. Their clinical and functional status were assessed pre-operatively on the day prior to surgery and the last follow up at one following the surgery with Tegner-Lysholm Score and 2000 IKDC scores. Results: The average pre operative Tegner- Lysolm score before surgery in Endobutton group was 56.636.7 and post op score at last follow up was 93.974.1 and for closed adjustable loop group it was 56.57.1 and 94.73.7 respectively. The average 2000 IKDC score before surgery in Endobutton group was 46.166.1and postop score at last follow up was 82.524.2 and for closed adjustable loop group it was 46.576.5 and 83.984.1 respectively. Two sample student t-test was conducted to compare the mean of post-operative Tegner-Lysolm score and 2000 IKDC for each group it showed P value for Tegner-Lysolm score to be 0.75 and that for 2000 IKDC score to be 0.7, which not statistically significant to reject the null hypothesis. Conclusion: Cortical suspension devices for femoral tunnel graft fixation are very efficient devices whether Fixed-length or adjustable length. Fixed-length and adjustable loop cortical suspension devices are equally effective in femoral fixation of graft in ACL reconstruction. Key words: Anterior cruciate ligament, cortical suspension device, Fixed-length loop device, Adjustable length loop device.

 
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