Stand-Alone Tibial Interference Screw Fixation and Tibial Interference Screw Plus Tibial Staple Fixation Produce Comparable Outcomes After Primary Anterior Cruciate Ligament Reconstruction Using Hamstring Autografts

Arthrosc Sports Med Rehabil. 2023 Oct 19;5(6):100810. doi: 10.1016/j.asmr.2023.100810. eCollection 2023 Dec.

Abstract

Purpose: To investigate the impact of adding a metal staple alongside the interference screw in tibial side graft fixation during anterior cruciate ligament reconstruction (ACLR).

Methods: All patients treated with autograft hamstring ACLR at our institution between January 2017 and December 2021 with a minimum 1-year follow-up were reviewed retrospectively. Patients treated with a stand-alone interference screw for tibial side fixation were compared with those treated with a combination of interference screw and staple. The primary outcome was failure of the reconstructed graft. Secondary outcomes were operative time, complication rate, and reoperation rate.

Results: A total of 497 patients met the study's inclusion and exclusion criteria. A combination of staple and interference screw was used in 167 patients (33.6%), whereas a standalone interference screw was used in 330 patients. There was no significant difference between the 2 groups in terms of operative time, complication rate, or failure rate. The mean follow-up was 23.25 (±13.29) months.

Conclusions: Our results demonstrate that augmenting the interference screw with a staple for tibial-side fixation in ACLR does not have a significant impact on operative time, reoperation rate, complications, or failure rates.

Level of evidence: Level III, retrospective cohort study.