Loose Fixation of Interference Screws Problem

If the screw is not put parallel to the tunnel, it may result in posterior penetration of the femoral tunnel. The screw may come loose in the joint. The appropriate size of screw, one that gives good purchase on the graft, must be used.

Solution

Use a two-pin passer to place the femoral screw in the femoral tunnel (Fig. 6.62). Visualize the screw guide wire in the notch for the tibial tunnel. If the guide wire is in the tunnel, the screw should follow the guide wire.

In soft tissue graft fixation, use a screw that is the same size in the femoral tunnel and one size larger in the tibial tunnel. With the patellar tendon graft, measure the space between the bone plug and the sizing cylinder. If the space is less than 2 mm, use a 7-mm screw. If the space is greater than 2 mm, use a larger screw.

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