Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association
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Comparative Study
Interference screw position and hamstring graft location for anterior cruciate ligament reconstruction.
Anterior cruciate ligament reconstruction with hamstring tendon graft and interference screw fixation has recently been considered. Concerns for the use of interference screws with soft tissue grafts include damage to the graft during screw insertion, decreased fixation strength, and a decrease in the bone-tendon contact area for healing within the tunnel when the screw is placed in an eccentric position. This last concern could be addressed by placing the interference screw centrally between the four limbs of the hamstring graft. ⋯ The maximum pullout force averaged 265.3 N for the screw placed in the eccentric position, and 244.7 N for the screw placed in the central position; these values were not significantly different. Placement of the interference screw in the central position did not compromise strength and it improves graft contact within the bone tunnel. Interference screw fixation, when applied against a bone plug, has been shown to consistently have a pullout force of more than 400 N.