Types Of Fixation Techniques Research Articles

A Long-term Comparison of Outcome of Arthroscopic Anterior Cruciate Ligament Reconstruction Using Bioabsorbable Interference Screw and Endobutton on Femur.

Arthroscopic anterior cruciate ligament (ACL) reconstruction is a very commonly done procedure in recent times. There is a need for a long-term outcome study of ACL reconstruction with a comparison between different types of fixation techniques. The graft fixation methods vary from aperture fixation (interference screws) to suspensory fixation methods (endobutton). Failure of graft incorporation and the development of tunnel widening (TW) after ACL reconstruction have been frequently reported in the long term in present literature. TW especially complicates revision ACL surgery. This is a prospective non-randomized clinical study of arthroscopic ACL reconstruction comparing the functional results between aperture fixation and suspensory fixation. Two groups of 14 patients who underwent autogenous hamstring ACL reconstruction with a minimum of 2-year follow-up evaluation were included in the study. The first group underwent aperture fixation with bioabsorbable interference screw at tibial and femoral side. The second group underwent suspensory fixation with endobutton fixation on the femoral side and biointerference screw on the tibial side. Both group patients were examined clinically before surgery, and at 3 months, 6 months, 1 year, and at 2 years. They were compared for functional outcome with Tegner Lysholm knee score. There was a significant improvement in functional outcome in both the groups for base and at 3 months, also for 3 months and 6 months but for 6 months-1 year. Group 2 is almost significant. This improvement in outcome in Group 2 is consistent from 1 year to 2 years. In our prospective study comparing the outcomes of functional outcomes of ACL reconstruction with aperture fixation versus suspensory fixation on the femur, which was evaluated using Tegner Lysholm knee score over a period of 2 years, suspensory fixation was found to be better. However, further studies involving a larger series of cases are required for a better evaluation of the outcome.

Patient Reported Outcomes Following Hindfoot Fusion Utilizing the Triple Arthrodesis Procedure

Category: Hindfoot; Ankle Arthritis Introduction/Purpose: Fusions are used as a salvage procedure to improve stability and return patient to regular functions of daily activities. Triple Arthrodesis is a fusion of three joints, talonavicular, subtalar, calcaneocuboid. There is limited literature on the patient-reported long-term outcomes for this procedure. The aim of this study is to quantify the patient-reported outcomes for the Triple Arthrodesis procedure. Methods: A retrospective analysis was conducted for patients that underwent Triple Arthrodesis at our facility from 2014-2021. Using the electronic medical record (EMR), basic patient demographics, time since surgery, presence of osteoarthritis or rheumatoid arthritis, development of infection, nonunion, hardware failure, and history of previous foot and ankle procedures were all noted. Additionally, we recorded the hardware used during the operation and whether concomitant procedures were performed during the time of surgery. To evaluate outcomes, we used the Patient Reported Outcomes Measurement Information System (PROMIS) survey and Foot Function Index (FFI) scores. Results: A total of 132 patients were included in this study with 50 participants completing the PROMIS and FFI surveys. The average time point at which the outcomes were collected was 5.50 years postoperatively. Postoperative PROMIS scores for physical function, pain interference, and depression were all within one standard deviation of the reference population. The average PROMIS physical function was 38.35, pain interference was 61.52, and depression was 49.82 for this population. The mean FFI scores were 58.56 for pain, 60.06 for disability, 48.06 for activity limitation. There was a significant decrease in postoperative pain scores when compared to preoperative pain of 5.4 to 2.55 (p=0.023). Four patients experienced wound infection, four patients experienced nonunion, six patients required revisional surgery, and three patients experienced hardware failure. Conclusion: Preliminary results Triple Arthrodesis may be beneficial in decreasing pain and lead variable long-term patient satisfaction. We plan to include further statistical analysis comparing the various types of fixation techniques used and the resultant PROMIS and FFI scores. Additionally, we are currently continuing patient calls to collect more completed PROMIS and FFI reports.

Mesh fixation techniques in primary ventral or incisional hernia repair.

Mesh fixation techniques in primary ventral or incisional hernia repair.

Healing at the interface between recipient sites and autologous block bone grafts affixed by either position or lag screw methods: a histomorphometric study in rabbits.

To compare the sequential healing at the interface gap occurring between autologous bone grafts and recipient sites using two types of fixation techniques. Twenty-four adult male New Zealand white rabbits were used. Two bone grafts were collected from the calvaria and secured to the lateral aspect of the angle of mandible in each animal. Cortical perforations at the recipient sites were performed. However, no modifications were applied to the graft for its adaptation to the recipient site. Two types of fixation techniques by position or lag screws were applied. This was done by preparing osteotomy holes smaller or larger than the screw diameter, respectively. The animals were sacrificed after 3, 7, 20, and 40days. After 3days, the distance between the graft and the recipient site was similar between the two different fixations. Due to the anatomical shapes of the recipient sites and grafts, the distance between the two parts was lower in the central region (<0.1mm) compared to the external regions of the graft (0.5-0.6mm). The first evidence of small amounts of new (woven) bone was seen after 7days, forming from the parent bone. The percentage increased after 20 and 40days. After 40days, the grafts were well incorporated within the recipient sites in both groups without any statistically significant difference. The present study did not show superiority of one method over another. A fixation to a recipient site with perforations may be sufficient for incorporating an autologous bone graft even if its adaptation is not perfect and irrespectively of the fixation method. Distances of approximately half millimeter were bridged with newly formed bone.

Mesh fixation techniques in primary ventral or incisional hernia repair

Mesh fixation techniques in primary ventral or incisional hernia repair