Cargando…

Subcortical Backup Fixation in ACL Reconstruction

Anterior cruciate ligament (ACL) injuries result in knee instability in a majority of patients. Repair and reconstruction techniques have continually evolved over the past several decades. ACL reconstruction outcomes are directly impacted by physical therapy with early range of motion, weightbearing...

Descripción completa

Detalles Bibliográficos
Autores principales: Gee, Shawn M., Zhou, Liang, Donohue, Michael A., Posner, Matthew A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8821247/
https://www.ncbi.nlm.nih.gov/pubmed/35155109
http://dx.doi.org/10.1016/j.eats.2021.10.006
_version_ 1784646370600157184
author Gee, Shawn M.
Zhou, Liang
Donohue, Michael A.
Posner, Matthew A.
author_facet Gee, Shawn M.
Zhou, Liang
Donohue, Michael A.
Posner, Matthew A.
author_sort Gee, Shawn M.
collection PubMed
description Anterior cruciate ligament (ACL) injuries result in knee instability in a majority of patients. Repair and reconstruction techniques have continually evolved over the past several decades. ACL reconstruction outcomes are directly impacted by physical therapy with early range of motion, weightbearing, and progressive strengthening. Therefore, the fixation must be sufficient to withstand the tensile and shear stresses across the graft construct during the biological healing phase. Occasionally, the primary fixation device is not strong enough to withstand these stresses. In turn, supplementary fixation devices, which are important especially in cases of revision ACL reconstruction, are imperfect. They occasionally become symptomatic, requiring hardware removal. Posts and washers require bicortical fixation, with moderate-sized holes in the tibia. Biocomposite screws rely on friction in the bone–screw interface, making them susceptible to failure. Tensioning can be problematic with the use of a post-and-washer construct. Subcortical fixation, which has not previously been described as a backup fixation method, provides several advantages. It requires a smaller, unicortical hole and provides fixation with a much lower profile than post-and-washer and interference-screw constructs. This is the first description of subcortical backup fixation in ACL reconstruction.
format Online
Article
Text
id pubmed-8821247
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Elsevier
record_format MEDLINE/PubMed
spelling pubmed-88212472022-02-11 Subcortical Backup Fixation in ACL Reconstruction Gee, Shawn M. Zhou, Liang Donohue, Michael A. Posner, Matthew A. Arthrosc Tech Technical Note Anterior cruciate ligament (ACL) injuries result in knee instability in a majority of patients. Repair and reconstruction techniques have continually evolved over the past several decades. ACL reconstruction outcomes are directly impacted by physical therapy with early range of motion, weightbearing, and progressive strengthening. Therefore, the fixation must be sufficient to withstand the tensile and shear stresses across the graft construct during the biological healing phase. Occasionally, the primary fixation device is not strong enough to withstand these stresses. In turn, supplementary fixation devices, which are important especially in cases of revision ACL reconstruction, are imperfect. They occasionally become symptomatic, requiring hardware removal. Posts and washers require bicortical fixation, with moderate-sized holes in the tibia. Biocomposite screws rely on friction in the bone–screw interface, making them susceptible to failure. Tensioning can be problematic with the use of a post-and-washer construct. Subcortical fixation, which has not previously been described as a backup fixation method, provides several advantages. It requires a smaller, unicortical hole and provides fixation with a much lower profile than post-and-washer and interference-screw constructs. This is the first description of subcortical backup fixation in ACL reconstruction. Elsevier 2022-01-20 /pmc/articles/PMC8821247/ /pubmed/35155109 http://dx.doi.org/10.1016/j.eats.2021.10.006 Text en https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Technical Note
Gee, Shawn M.
Zhou, Liang
Donohue, Michael A.
Posner, Matthew A.
Subcortical Backup Fixation in ACL Reconstruction
title Subcortical Backup Fixation in ACL Reconstruction
title_full Subcortical Backup Fixation in ACL Reconstruction
title_fullStr Subcortical Backup Fixation in ACL Reconstruction
title_full_unstemmed Subcortical Backup Fixation in ACL Reconstruction
title_short Subcortical Backup Fixation in ACL Reconstruction
title_sort subcortical backup fixation in acl reconstruction
topic Technical Note
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8821247/
https://www.ncbi.nlm.nih.gov/pubmed/35155109
http://dx.doi.org/10.1016/j.eats.2021.10.006
work_keys_str_mv AT geeshawnm subcorticalbackupfixationinaclreconstruction
AT zhouliang subcorticalbackupfixationinaclreconstruction
AT donohuemichaela subcorticalbackupfixationinaclreconstruction
AT posnermatthewa subcorticalbackupfixationinaclreconstruction