A prospective study was undertaken to assess the effectiveness of the double-looped semitendinosus and gracilis graft secured with a biodegradable interference fixation screw (BioScrew). To be included, a patient had to meet the following criteria: a complete ACL tear, knee instability as manifested by positive Lachman test and positive pivot-shift test, a KT-1000 manual maximum side-to-side difference of greater than 5 mm, and a commitment to return for at least two years of follow-up. Patients were excluded if they had an active infection preoperatively or multiple coincident ligament injuries (PCL, MCL, LCL, posterolateral corner). Previous knee ligament reconstruction was not an exclusionary criterion, and several of the patients included had revision surgery.
Preoperative assessments included a history, physical examination and radiographs. Baseline KT measurements at 20lbs, 30lbs, and maximum manual side-to-side difference were obtained. The surgical findings and procedures performed were recorded.
All patients underwent the same procedure: an arthroscope-assisted ACL reconstruction using a double-looped semitendinosus and gracilis autograft from the ipsilateral limb. The graft was secured at the proximal and distal sites with a BioScrew, and fixation was periodically supplemented on the tibial side with a periosteal button (Ethicon, J&J, Boston, MA).
Postoperative assessment included the IKDC score, KT tests, examination, and radiographs. The BioScrews are composed of purified poly
L-Lactide (containing 45% crystalline polymer). These screws were available in 7, 8, and 9 mm sizes for the tibia and femur. A 25-mm long screw was used in each case. These screws are cannulated and are placed over a Nitinol guide wire to prevent divergent placement of the screw.
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