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Date of Graduation
Capstone Project (On-Campus Access Only)
Master of Science in Physician Assistant Studies
Judy Ortiz, MS, PA-C, MHS
Warren Krammer III, Orthopedic Surgeon
Background: Anterior cruciate ligament reconstruction has become one of the most successful procedures in orthopedic medicine. Currently, the weak link lies in the fixation . The fixation must be able to resist slippage during cyclic loading of the graft during the first 2 months after surgery prior to conversion from mechanical to biological fixation. Several studies have shown Intrafix screws to work well with fixation in the femur; however, security of the fit in the tibia is still under debate.
Study Design: Prospective double-blinded study Methods: In 30 patients anterior ligament reconstruction was performed using a four-stranded hamstring graft using either an Intrafix sheath and screw combination or Delta screw for tibial fixation. The subjects were then evaluated with IKDC subjective surveys, physical examinations, KT-1000 measurements, quadriceps and calf girth measurements and radiographic examinations.
Results/Conclusion: No statistically significant differences in IKDC subjective reports, KT-1000 measurements, quadriceps and calf musculature strength and girth, and postoperative radiographic examination were observed between the two different types of fixation devices. Clinical Relevance: Improvements in fixation devices, specifically the Intrafix and Delta Screws, have been proven to improve tibial fixation and reduce injury to soft tissue grafts. At this time our study shows no statistically significant difference between these fixation devices.
Schlangen, Amy M., "ACL reconstruction: Evaluation of tibial fixation with intrafix screw and sheath versus delta screw." (2003). School of Physician Assistant Studies. 332.