AAOS2017: Enlargement at different tunnel depths with β-TCP-containing vs PLLA screws

Study Type: Randomized Trial
OE Level of Evidence: N/A
Journal Level of Evidence: N/A
CONFERENCE ACE REPORTS
This ACE Report is a summary of a conference presentation or abstract. The information provided has limited the ability to provide an accurate assessment of the risk of bias or the overall quality. Please interpret the results with caution as trials may be in progress and select results may have been presented.
Synopsis
57 patients scheduled for double-bundle anterior cruciate ligament (ACL) reconstruction were randomized to tibial fixation with either the use of pure poly-L-lactic acid interference screws or screws containing beta (B)-tricalcium phosphate (TCP). Patients were assessed on CT at 12 months for tibial tunnel enlargement at four tunnel depths: at the joint line, mid-tunnel, mid-screw, and at the tunnel aperture. Both groups demonstrated Please login to view the rest of this report. Please login to view the rest of this report.
Why was this study needed now?
Tunnel widening following ACL reconstruction is a well-documented complication that can lead to failure. To promote bony integration and biocompatibility, interference screws containing beta-tricalcium phosphate have been used for fixation of the graft in the tibial tunnel. However, few studies have conclusively evaluated the effect of these screws on tunnel widening, hence, the need for this randomized study.
What was the principal research question?
In double-bundle ACL reconstruction, is there any significant difference in tibial tunnel enlargement after 12 months between fixation with beta (B)-tricalcium phosphate containing interference screws and fixation with poly-L-lactic acid interference screws?
Population: 57 patients scheduled for double-bundle ACL reconstruction using a hamstring autograft.
Intervention: B-TCP interference screw group: Tibial fixation was performed using interference screws containing beta-tricalcium phosphate (B-TCP) (n=29)
Comparison: PLLA interference screw group: Tibial fixation was performed using interference screws composed of poly-L-lactic acid (PLLA) (n=28)
Outcomes: The cross-sectional area of the tibial tunnel was measured at the joint line, mid-tunnel, mid-screw, and at the tunnel aperture on CT.
Methods: RCT
Time: CT was performed immediately postoperatively and at 12 months postoperatively.
What were the important findings?
CONTENT IS LOCKED
What should I remember most?
How will this affect the care of my patients?
The authors responsible for this critical appraisal and ACE Report indicate no potential conflicts of interest relating to the content in the original publication.