Comparison of Clinical and Radiologic Outcomes and Second-Look Arthroscopic Findings After Anterior Cruciate Ligament Reconstruction Using Fixed and Adjustable Loop Cortical Suspension Devices

Abstract

To compare clinical and radiological outcomes, including tunnel widening, and to evaluate graft status by second-look arthroscopy after anterior cruciate ligament (ACL) reconstruction using 2 different femoral cortical suspension devices (fixed and adjustable loop). Seventy-nine patients were included for this study. The patients were divided into 2 groups, 41 patients of fixed loop group (EndoButton) and 38 patients of adjustable loop group (TightRope). The Tegner activity, Lysholm knee score, Lachman test, and pivot-shift test were compared between the 2 groups. Anterior stress radiographs and femoral tunnel widening on plain radiographs were also compared. Twenty-seven patients (66%) in the EndoButton group and 21 patients (55%) in the TightRope group underwent the second-look arthroscopy. At the final follow-up, the mean Tegner activity, Lysholm, and International Knee Documentation Committee scores were improved in both groups and there were no statistically significant differences (5.1 ± 1.6 and 5.5 ± 2.1, P= .312; 90.4 ± 7.8 and 91.0 ± 6.5, P= .525; and 87.4 ± 6.7 and 88.7 ± 5.3, P= .127, respectively). There were no statistical significances in the both groups in terms of Lachman test and pivot-shift tests (P= .392, .559) as well as anterior stress radiographs (mean 3.2 ± 1.4mm and 2.9 ± 1.1mm, P= .343). Moreover, radiologic measurements comparing femoral tunnel widening at proximal and distal half also showed no significant differences (P= .540 and .412 on anteroposterior view; P= .254 and .437 on lateral view). In the second-look arthroscopy findings for graft tear and synovial coverage, there were no significant differences (P= .784 and .897). Both fixed loop and adjustable loop devices in ACL reconstruction provided good clinical and radiological outcomes. In patients with both devices, femoral tunnel widening at proximal and distal portion have no significant differences after ACL reconstruction. Moreover, second-look arthroscopy revealed no significant differences in terms of synovial coverage and rupture of the graft. Level II, prospective comparative study.