Hoefnagels, N.H. (2013) A retrospective study to the patient-reported outcome after an anterior cruciate ligament reconstruction: a comparison between Endobutton® and TransFix®. thesis, Medicine.
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Abstract
Background: Traumatic injuries of the anterior cruciate ligament (ACL) are among the most common sports injuries to the knee. Treatment consists of conservative- or surgical treatment. In surgical ACL-reconstructions, currently there is no gold standard in the fixation method of the ACL-graft to the femur. Extracortical- and transfemoral fixation both show decent biomechanics. Thereby, both procedures give comparable stability and there is an indication that the functional outcome is similar as well. The purpose of this retrospective cohort study is to objectify and compare the patient-reported outcomes of an extracortical fixation (Endobutton®) and a transfemoral fixation (TransFix®), 2-3 years after ACL-reconstruction. Patients and methods: All 112 patients included in this study, underwent an ACL-reconstruction in the Isala Klinieken Zwolle in 2010. Femoral fixation was either with Endobutton® (n=53) or with TransFix® (n=59). Primary outcome was the patient-reported outcome measured by the Knee Injury and Osteoarthritis Outcome Score (KOOS). Secondary outcome was the patient-reported outcome, determined by the International Knee Documentation Committee (IKDC) subjective knee evaluation form, the Lysholm knee score and the Tegner Activity Scale (TAS). Furthermore, possible differences in the number of required additional surgical procedures, the duration of the ACL-reconstruction and the contentment of the patients were objectified. The possible correlation of these factors with the patient-reported outcome was objectified as well. Additionally, the surgeon and the patient characteristics (gender/age/BMI) were correlated to patient-reported outcome. Results: There was no significant difference in patient-reported outcome between Endobutton® and TransFix® measured by the KOOS (p-value >0.05). No major differences were seen in results of the IKDC, Lysholm and TAS. Patient characteristics, duration of surgical procedures and contentment of the patients were comparable between the two methods and did not correlate with patient-reported outcome. Patient-reported outcome of this study did not correlate with the individual surgeon. There were more re-operations required in the TransFix® group than in the Endobutton® group (respectively 20.34% and 7.55%), although differences were not considered significant. Patient-reported outcome is significantly lower in patients who underwent a re-operation. The mean follow-up was 2 year and 288 days after ACL-reconstruction. Conclusion: The patient-reported outcome of Endobutton® and Transfix® are comparable after 2-3 year follow-up. Results indicate that the number of required additional procedures is remarkably higher in the population with TransFix®. Since patient-reported outcomes are significantly lower in patients who underwent a re-operation, further analysis is clinically relevant.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Zuurmond, Dr. R.G. and Isala Klinieken and orthopaedic department |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:56 |
| Last Modified: | 25 Jun 2020 10:56 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1625 |
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