Comparison of Outcomes of Anterior Cruciate Ligament Reconstruction with Hybrid Tibial Fixations Between Adjustable Suspensory Device with Interference Screw and Cortical Screw Post with Interference Screw: A Prospective Comparative Cohort Study

Abstract Background: Previous studies have compared different kinds of fixations for anterior cruciate ligament reconstruction. Nevertheless, there is no optimal method to date. Furthermore, to the best of authors’ knowledge, there is no article discussing the combination of suspensory device and interference screw for hybrid tibial fixation.Methods: In total, 66 patients (34, modified group; 32, traditional group) were enrolled. Their International Knee Documentation Committee score, Tegner score, and Single Assessment Numeric Evaluation score were evaluated after a 2-year follow-up. The range of motion, anterior knee irritation and Lachman test were assessed at least 12 months after surgery. To evaluate tunnel widening, anteroposterior and lateral view radiography was conducted 1 day after surgery and at least 12 months later. A more than 10% change in the tunnel was considered as tibial tunnel widening. Mann–Whitney U test, independent t test, and chi-squared test were used to compare the variables between the groups.Results: No variable except gender (P = 0.006) showed any significant difference with regard to demographic data. Functional scores and physical examinations also showed no statistically significant difference between the groups. Patients who underwent traditional hybrid fixation were more prone to anterior knee irritation (P = 0.028). Further, more patients who underwent traditional hybrid fixation showed greater percentage of tunnel widening in the lateral view of radiographs (P = 0.033). No significant difference was observed in the anteroposterior view of radiographs between the groups (P = constant).Conclusion: Patients who underwent modified hybrid tibial fixation had similar clinical outcomes at 2-year follow-up, but less tibial tunnel widening in lateral view radiographs and less anterior knee irritation at 1-year follow-up compared with patients who underwent traditional hybrid tibial fixation.Trial Registration:Joint Institutional Review Board of Taipei Medical University, Taipei, Taiwan (No: N201805094).Study Design:Prospective comparative cohort study; Level of evidence, II.