Clinical and functional outcome of arthroscopic anterior cruciate ligament reconstruction using autologous graft with biodegradable interference screw and adjustable loop endobutton: a prospective study
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20263282Keywords:
Arthroscopic ACL reconstruction, Autologous hamstring graft, Biodegradable interference screw, Adjustable-loop endobutton, Lysholm knee score, IKDC scoreAbstract
Background: Anterior cruciate ligament (ACL) injury is a common cause of knee instability, functional impairment, and increased risk of secondary meniscal injury and early osteoarthritis. Arthroscopic ACL reconstruction is the gold standard treatment for symptomatic ACL tears. Secure graft fixation using an autologous hamstring graft, biodegradable interference screw, and adjustable-loop Endobutton provides stable fixation, promotes graft incorporation, and facilitates early rehabilitation.
Methods: This prospective observational study included 60 patients with symptomatic ACL rupture treated at the Department of Orthopaedics, Sardar Patel Medical College and Associated Group of Hospitals, Bikaner. Preoperative assessment included clinical examination, MRI, Lysholm score, IKDC grading, and stability tests. All patients underwent arthroscopic ACL reconstruction using an autologous hamstring graft with femoral fixation by an adjustable-loop Endobutton and tibial fixation using a biodegradable interference screw. Functional outcomes and complications were evaluated during follow-up.
Results: The mean patient age was 28.9±6.3 years, and 81.7% were male. At final follow-up, 68.3% achieved an excellent Lysholm score, while 46.7% and 40.0% were graded as normal and nearly normal, respectively, on the IKDC scale. Most patients demonstrated restored knee stability with minimal complications. No implant failure, deep infection, or neurovascular injury was observed.
Conclusion: Arthroscopic ACL reconstruction using an autologous hamstring graft with biodegradable interference screw and adjustable-loop Endobutton provides excellent functional outcomes, reliable knee stability, and a low complication rate, making it a safe and effective treatment for symptomatic ACL injuries.
References
Sanders TL, Maradit Kremers H, Bryan AJ, Larson DR, Dahm DL, Levy BA. Incidence of anterior cruciate ligament tears and reconstruction: A 21-year population-based study. Am J Sports Med. 2016;44(6):1502-7.
John R, Dhillon MS, Syam K, Prabhakar S, Behera P, Singh H. Epidemiological profile of sports-related knee injuries in northern India: An observational study at a tertiary care centre. J Clin Orthop Trauma. 2016;7(3):207-11.
Kochhal N, Thakur R, Gawande V. Incidence of anterior cruciate ligament injury in a rural tertiary care hospital. J Fam Med Prim Care. 2019;8(12):4032-5.
Singh S, Shaunak S, Shaw SCK, Anderson JL, Mandalia V. Adjustable loop femoral cortical suspension devices for anterior cruciate ligament reconstruction: A systematic review. Indian J Orthop. 2020;54(4):426-43.
Gamboa JT, Shin EC, Pathare NP, McGahan PJ, Chen JL. Graft retensioning technique using an adjustable-loop fixation device in arthroscopic anterior cruciate ligament reconstruction. Arthrosc Tech. 2018;7(2):185-91.
Kamitani A, Hara K, Arai Y. Adjustable-loop devices promote graft revascularization in the femoral tunnel after ACL reconstruction: Comparison with fixed-loop devices using magnetic resonance angiography. Orthop J Sports Med. 2021;9(2):2378.
Xu Y, Ao Y, Wang J. Comparison of bioabsorbable and metallic interference screws for graft fixation during ACL reconstruction: A meta-analysis of randomized controlled trials. Am J Sports Med. 2021;49(12):3435-46.
Yan L, Li JJ, Zhu Y. Interference screws are more likely to perform better than cortical button and cross-pin fixation for hamstring autograft in ACL reconstruction: A Bayesian network meta-analysis. Knee Surg Sports Traumatol Arthrosc. 2021;29(6):1850-61.
Bhatt PR, Devpura MM, Rathi PP, Sable AS. Comparative analysis of the outcome between aperture and suspensory graft fixation methods in anterior cruciate ligament reconstruction surgeries: A systematic review. Int J Res Orthop. 2024;10(5):1014-9.
Elmholt SB, Nielsen TG, Lind M. Adjustable-loop implants are non-inferior to fixed-loop implants for femoral fixation in anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. 2023;31:1723-32.
Elmholt SB, Lind M. Fixed-loop vs adjustable-loop cortical button devices for femoral fixation in ACL reconstruction: A systematic review and meta-analysis. J Exp Orthop. 2022;9:87.
Beyer J, Jones R, Igo I, Furyes AR, Liu J, Sohn DH. Comparison of graft type and fixation method in anterior cruciate ligament reconstruction: A systematic review and meta-analysis based on randomized controlled studies. JBJS Rev. 2024;12(4):672.
Sayampanathan AA, Howe BK, Bin Abd Razak HR. Epidemiology of surgically managed anterior cruciate ligament ruptures in a sports surgery practice. J Orthop Surg (Hong Kong). 2017;25(1):2389.
Bourke HE, Gordon DJ, Salmon LJ. The outcome at 15 years of endoscopic anterior cruciate ligament reconstruction using hamstring tendon autograft for isolated anterior cruciate ligament rupture. J Bone Joint Surg Br. 2012;94(5):630-7.
Kiapour AM, Murray MM. Basic science of anterior cruciate ligament injury and repair. Bone Joint Res. 2014;3(2):20-31.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 B. L. Khajotia, Manish Choudhary, Pradeep Singh, Rajendra Meena

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.