CROSS-PIN FEMORAL FIXATION - A NEW TECHNIQUE FOR HAMSTRING ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION OF THE KNEE

A new method of femoral fixation for arthroscopic anterior cruciate li gament (ACL) reconstruction using semitendinosus and gracilis (ST/G) t endons is presented. Biomechanical evaluation of the method was perfor med with pullout tests using animal tissues simulating fixation of ST/ G tendons passing around a 2.5-mm pin placed transversely through a fe moral tunnel. Clinical assessment of 22 patients was performed accordi ng to IKDC, Tegner, Lysholm, isokinetic strength, and KT1000 standards . Fixation strengths ranged from 725 N to 1,600 N for yield and maxima l loads to failure for 35-mm to 70-mm cross-pins. Clinical results at mean follow-up of 30 months showed one traumatic failure, IKDC 86% nor mal or nearly normal, Tegner 6 ave, Lysholm 93 ave, KT1000 86% < 3 mm side-to-side difference on maximal manual evaluation, and isokinetic s trength testing of quadriceps 8% deficit with hamstrings 8% deficit. C ross-pin fixation of ST/G tendons may be one of the strongest modes of femoral graft attachment yet devised. Our clinical outcomes in this i nitial series compare well with previous reports of ACL reconstruction regardless of graft or technique.