Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Orthopedic Surgery

Background: press-fit fixation has been advocated to achieve tendon to bone healing Hypothesis: Fixation of hamstring tendon grafts with a press fit (PF) bone plug gives good knee stability compared with interference screw (IS) fixation. Study design: Prospective randomized controlled trial; level of evidence I. Methods: From April 2011 to September 2015, a prospective randomized controlled study was undertaken to compare between two types of fixation for ACL graft (PF) and (IS) technique used in ACL reconstruction using hamstring tendons. 100 patients were operated; graft was fixed in 50 knees using (IS) and the other 50 knees fixed by (PF) bone plug. The follow up at 1 week, 2 weeks, 6 weeks, 12 weeks, 6 months and yearly afterward. Assessment (subjective, objective and instrumental) was done at 6 months post operatively. Results: There is no any significant differences between both group in subjective and instrumental evaluation, but the (IS) is better in ADT as 92% rated as normal, while 72 only in (PF) group, but the (PF) is better in ROM 96% rated as normal to nearly normal while 86% in (IS), post-operative effusion where 98% rated normal to nearly normal in (PF) while 88% in (IS) and pivot test where 96% rated normal to nearly normal in (PF) while 78% in (IS). Conclusion: both (PF) and (IS) fixation techniques lead to high number of very good to good results after ACL reconstruction, the (PF) is better in some objective aspects in addition to be biological, economic, and least technique with bone loss

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