EVALUATION OF ACL TITANIUM SCREWS IN KNEE IMPLANTS: CLINICAL OUTCOMES AND COMPLICATIONS
Main Article Content
Keywords
Anterior Cruciate Ligament, Titanium Screws, Graft Fixation, Bone Patellar Tendon Bone
Abstract
Background: Anterior cruciate ligament (ACL) injuries are frequent and can cause instability and reduced knee joint functioning. Restoring knee stability and function is the goal of ACL reconstruction procedures, which include Bone Patellar Tendon Bone (BPTB) graft fixation with titanium screws. Despite the potential, this approach has demonstrated, a thorough assessment of its clinical results and consequences is necessary.
Objective: This study aimed to assess the clinical outcomes and complications related to ACL titanium screws in knee implants, with a specific focus on BPTB graft fixation.
Methodology: This prospective observational study conducted at Orthopaedic B Unit, Ayub Teaching Hospital, Abbottabad from January 2021 to December 2023 aimed to assess the clinical outcomes and complications following ACL reconstruction using BPTB graft fixation with titanium screws. To guarantee validity and relevance, strict inclusion and exclusion criteria were used to 216 individuals who were selected using systematic sampling. Preoperative evaluations, intraoperative observations, and postoperative follow-ups were all part of the data gathering process, which allowed for a thorough assessment of safety and effectiveness. The study used statistical analysis, including both descriptive and inferential techniques, to examine correlations between clinical outcomes and complications and demographic attributes.
Results: The results of ACL repair using titanium screw-based BPTB graft fixation were investigated in this prospective observational research. A demographic examination of 216 participants showed that 68.52% of them were male and that their average age was 31.5 years. Sixty-two percent had a normal BMI. Over time, clinical results improved: at 12 months after surgery, 94.37% of patients reported increased knee stability, and 95.83% reported improved functional capacity. ACL re-tear (3.24%), knee stiffness (5.56%), discomfort (4.63%), graft failure (2.78%), implant failure (1.85%), and infection (3.70%) were among the complications. Significant correlations between postoperative intervals and clinical outcomes were shown by regression analysis (p < 0.05).
Conclusion: ACL reconstruction with titanium screw-based BPTB graft fixation yields improved knee stability and function, with manageable complication rates, underscoring the need for personalized patient care and ongoing research for optimization.
References
2. Marques JB, Paul DJ, Graham-Smith P, Read PJ. Change of direction assessment following anterior cruciate ligament reconstruction: a review of current practice and considerations to enhance practical application. Sports Medicine. 2020 Jan;50:55-72.
3. Van Grinsven S, Van Cingel RE, Holla CJ, Van Loon CJ. Evidence‐based rehabilitation following anterior cruciate ligament reconstruction. Knee Surgery, Sports Traumatology, Arthroscopy. 2010 Aug;18(8):1128-44.
4. Shelton WR, Fagan BC. Autografts commonly used in anterior cruciate ligament reconstruction. JAAOS-Journal of the American Academy of Orthopaedic Surgeons. 2011 May 1;19(5):259-64.
5. Perez, J.R., Emerson, C.P., Barrera, C.M., Greif, D.N., Cade, W.H., Kaplan, L.D. and Baraga, M.G., 2019. Patient-reported knee outcome scores with soft tissue quadriceps tendon autograft are similar to bone–patellar tendon–bone autograft at minimum 2-year follow-up: a retrospective single-center cohort study in primary anterior cruciate ligament reconstruction surgery. Orthopaedic journal of sports medicine, 7(12), p.2325967119890063.
6. Sgardelis P, Naqvi G, Servant C. Minimally Invasive Bone-Patellar Tendon-Bone Graft Harvest Is Associated With Less Frequent Anterior Knee Pain at Rest Than Hamstring Graft Harvest After Anterior Cruciate Ligament Reconstruction at the 1-Year Follow-Up. Arthroscopy, Sports Medicine, and Rehabilitation. 2023 Aug 1;5(4):100766.
7. Wang J, Xu J, Fu W, Cheng W, Chan K, Yung PS, Qin L. Biodegradable magnesium screws accelerate fibrous tissue mineralization at the tendon-bone insertion in anterior cruciate ligament reconstruction model of rabbit. Scientific Reports. 2017 Jan 10;7(1):40369.
8. Buerba RA, Boden SA, Lesniak B. Graft selection in contemporary anterior cruciate ligament reconstruction. JAAOS Global Research & Reviews. 2021 Oct 1;5(10):e21.
9. Ramos DM, Dhandapani R, Subramanian A, Sethuraman S, Kumbar SG. Clinical complications of biodegradable screws for ligament injuries. Materials Science and Engineering: C. 2020 Apr 1;109:110423.
10. Pape D, Seil R, Adam F, Gödde S, Georg T, Rupp S, Kohn D. Blood loss in anterior cruciate ligament (ACL) reconstruction with and without intercondylar notchplasty: does it affect the clinical outcome?. Archives of orthopaedic and trauma surgery. 2001 Nov;121:574-7.
11. McDermott E, DeFoor MT, Blaber OK, Aman ZS, DePhillipo NN, Dekker TJ. Biomechanical comparison of anterior cruciate ligament reconstruction fixation methods and implications on clinical outcomes. Annals of Joint. 2023;8.
12. He X, Yang XG, Feng JT, Wang F, Huang HC, He JQ, Hu YC. Clinical outcomes of the central third patellar tendon versus four-strand hamstring tendon autograft used for anterior cruciate ligament reconstruction: a systematic review and subgroup meta-analysis of randomized controlled trials. Injury. 2020 Aug 1;51(8):1714-25.
13. Drogset JO, Straume LG, Bjørkmo I, Myhr G. A prospective randomized study of ACL-reconstructions using bone-patellar tendon-bone grafts fixed with bioabsorbable or metal interference screws. Knee Surgery, Sports Traumatology, Arthroscopy. 2011 May;19:753-9.
14. Chen JL, Allen CR, Stephens TE, Haas AK, Huston LJ, Wright RW, Feeley BT, Multicenter ACL Revision Study (MARS) Group. Differences in mechanisms of failure, intraoperative findings, and surgical characteristics between single-and multiple-revision ACL reconstructions: a MARS cohort study. The American journal of sports medicine. 2013 Jul;41(7):1571-8.
15. Soni S, Brahmbhatt V, Tolani M, Soni H, Pathan SR, Shroff M, Sharma KB, Brahmbhatt VK, Pathan S, Shroff MR. Functional Outcomes in Anterior Cruciate Ligament (ACL) Reconstruction: A Nine-Month Follow-up Study Using Lysholm Score in a Rural Tertiary Care Center in India. Cureus. 2024 Feb 3;16(2).
16. Roethke LC, Braaten JA, Rodriguez AN, LaPrade RF. Revision Anterior Cruciate Ligament Reconstruction (ACLR): causes and how to minimize primary ACLR failure. Archives of Bone and Joint Surgery. 2023;11(2):80.
17. Rousseau R, Labruyere C, Kajetanek C, Deschamps O, Makridis KG, Djian P. Complications after anterior cruciate ligament reconstruction and their relation to the type of graft: a prospective study of 958 cases. The American journal of sports medicine. 2019 Sep;47(11):2543-9.
18. Palazzolo A, Rosso F, Bonasia DE, Saccia F, Rossi R. Uncommon complications after anterior cruciate ligament reconstruction. Joints. 2018 Sep;6(03):188-203.
19. Busam ML, Provencher MT, Bach Jr BR. Complications of anterior cruciate ligament reconstruction with bone-patellar tendon-bone constructs: care and prevention. The American journal of sports medicine. 2008 Feb;36(2):379-94.
20. Mehta SP, Fulton A, Quach C, Thistle M, Toledo C, Evans NA. Measurement properties of the lower extremity functional scale: a systematic review. journal of orthopaedic & sports physical therapy. 2016 Mar;46(3):200-16.
21. Çelik D, Coşkunsu D, Kılıçoğlu Ö, Ergönül Ö, Irrgang JJ. Translation and cross-cultural adaptation of the international knee documentation committee subjective knee form into Turkish. journal of orthopaedic & sports physical therapy. 2014 Nov;44(11):899-909.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Muhammad Adeel
Assistant Professor, Orthopaedic B Unit, Ayub Teaching Hospital, Abbottabad, Pakistan
Muhammad Tayab
PGR, Orthopaedic B Unit, Ayub Teaching Hospital, Abbottabad, Pakistan
Muhammad Faizan Aziz
PGR, Orthopaedic B Unit, Ayub Teaching Hospital, Abbottabad, Pakistan
Zaheer Ahmad
PGR, Orthopaedic B Unit, Ayub Teaching Hospital, Abbottabad, Pakistan
Ijaz ur Rehman
PGR, Orthopaedic B Unit, Ayub Teaching Hospital, Abbottabad, Pakistan
Muhammad Iltaf
House Officer, Orthopaedic B Unit, Ayub Teaching Hospital, Abbottabad, Pakistan
Zainab Fida
House Officer, Orthopaedic B Unit, Ayub Teaching Hospital, Abbottabad, Pakistan