Tripled semitendinosus anterior cruciate ligament reconstruction with Endobutton fixation - A 2-3-year follow-up study of 35 patients

We evaluated the clinical outcome of tripled semitendinosus tendon ACL reco nstruction with femoral Endobutton (Acufex, Smith&Nephew, Andover, MA) and tibial Suture Washer (Acufex, Smith&Nephew, Andover, MA) (n 29) or post scr ew fixation (n 6) in 35 patients on an average of 28 (2037) months after su rgery, On the basis of IKDC criteria, 22 patients showed a normal or nearly normal knee function and 25 patients had a KT 1000 maximal manual side-to- side difference of 15 mm at follow-up. Subjectively, 28 patients graded the ir knee function as normal or nearly normal. The average Lysholm score was 88 points, average OAK score 90 points and average modified HSS score 93 po ints, 19 patients reached their preinjury level of activity at followup, Th e postoperative Lachman test was less than or equal to 1+ in 24 patients an d 24 patients also showed an absent pivot shift. Significant bone tunnel en largement occurred in 26 patients on the femoral side and in 23 patients on the tibial side. We found no correlation between bone tunnel enlargement a nd clinical outcome. The clinical outcome of tripled semitendinosus tendon ACL reconstruction wi th Endobutton fixation on the femoral side was not entirely satisfactory. T he procedure was associated with a high incidence of bone tunnel enlargemen t in this series.