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

Background: Rotational laxity has been demonstrated to persist, even in the face of a well-performed Anterior cruciate ligament (ACL) reconstruction.The iliotibial band (ITB) has also been shown to have an impact on the control of anterolateral rotational laxity. In particular, recent research would suggest that the capsulo-osseous layer of the ITB, is a major contributor to anterolateral rotational control. Methods: From December 2018 to December 2020, a prospective randomized (simple randomization) analytical clinical study was done to compare the functional outcome of group of patients undergoing ITB for extra articular augmentation of ACL Reconstruction using staple versus group of patients using interference screw. Results: Upon comparing thepostoperative, the primary finding is there was significant improvement of pivot shift in both groups with (100 % grade A pivot shift) in group A and (85 % grade A pivot shift) and (15% grade B pivot shift) in group B. So, the primary finding in this study is significant rotational control. The secondary finding is there was statistically significantdifferencein the postoperative IKDC objective scorebetween the 2 groups (p= 0.004). The reason for that is the postoperative lateral sided pain over iliotibial band incisional scar, there was statistically significant difference between the 2 groups (p= 0.001), in group A (60.0%) were graded as (A) and (40.0%) were graded as (C) but in group B (80.0%) were graded as (A) and (20.0%) were graded as (B). And so, after surgery, (35.0%) had removed staple in group (A) and (0.0%)patients had removed interference screw in group B. There was statistically high significant difference on comparing results in favor of postoperative results (p 0.008).Suggesting the use of interference screw rather than staple, when the same point of fixation of ITB tenodesis as described in the technique was used

Issued also as CD