Vishal Singh1, Alokeshwar Sharma2, Avinash Gundavarapu3, Tejas Patel4, Santosh Kumar M.5
BACKGROUND
Traditionally, metallic interference screws were considered to have increased
resistance to load than bio absorbable screws in anterior cruciate ligament (ACL)
reconstruction. We did a comparative evaluation of biodegradable and metallic
interference screws for tibial sided ACL reconstruction and also analysed
complications, compared clinical outcome, did imaging study of ACL single bundle
reconstruction by using titanium & newer poly–L-lactic acid (PLLA) bio absorbable
screws to determine as to whether bio absorbable screw which costs double the
metallic screw, is functionally better than standard metallic screws.
METHODS
This is a prospective comparative study conducted among 50 patients aged
between 15 and 55 years with clinical and MRI confirmation of complete ACL tear,
treated arthroscopically with ACL reconstruction with either bio absorbable (group
1) or metallic (group 2) interference screw and both the groups were compared
on follow up for an average duration of 12 months. Lysholm and Gillquist Knee
Scoring Scale were used and outcome scores were divided into excellent, good,
fair and poor.
RESULTS
In our study 41 patients were males and 9 were females. Bio screw was used in
24 males and 6 female patients. Metallic screw was used in 17 males and 3
females. Outcome score was excellent in 26 (52 %) cases, good in 18 (36 %)
cases, fair in 4 (8 %) cases, poor in 2 (4 %) cases. The mean Lysholm score in
bio absorbable group was 93.13 and in metallic group was 89.70. Knee effusion
was higher in bio screw group and infection rate was higher in metallic group.
CONCLUSIONS
In our study, the difference between bio absorbable screw group and metallic
screw group was insignificant with regard to final patient outcome. Final
osseointegration was better with bio absorbable screw, but increased cost of
implant and almost same results compared to metallic screw does not make the
bio absorbable screw superior to its counterpart.
