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. 2022 Dec 5;58(12):1787.
doi: 10.3390/medicina58121787.

Comparison of Clinical and Radiographic Outcomes According to the Presence or Absence of a Posterior Draw Force during Graft Fixation in Anterior Cruciate Ligament Reconstruction

Jin-Ho Cho  1 , Hyun Il Lee  1 , Jae Won Heo  1 , Sung-Sahn Lee  1
Affiliations

Comparison of Clinical and Radiographic Outcomes According to the Presence or Absence of a Posterior Draw Force during Graft Fixation in Anterior Cruciate Ligament Reconstruction

Jin-Ho Cho et al. Medicina (Kaunas). .

Abstract

Background and Objectives: A reduction forced toward the posterior side during graft fixation may help to lessen anterior tibial translation after ACL reconstruction. The purpose was to compare the clinical and radiological outcomes of graft fixation when a posterior draw was used and when it was not used during anterior cruciate ligament (ACL) reconstruction surgery. Materials and Methods: Of 110 patients who had undergone primary arthroscopic ACL reconstruction between January 2017 and August 2020, in all, 76 patients had been operated on without a posterior draw (non-draw group), and 34 patients had received surgery with a posterior draw (draw group). The results of the Lachman test and the pivot-shift test, the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) indexes, the Lysholm scores, the International Knee Documentation Committee (IKDC) subjective scores, and side-to-side difference (STSD) on stress radiography were compared between the two groups. Results: The postoperative WOMAC indexes, Lysholm scores, and IKDC subjective scores were similar across both groups. Postoperative STSD (2.4 ± 2.2 for the non-draw group vs. 2.0 ± 2.2 for the draw group; p = 0.319) and change in STSD (3.5 ± 3.5 for preoperative STSD vs. 4.3 ± 4.4 for postoperative STSD; p = 0.295) were not superior in the draw group. Conclusions: The take-home message is that graft fixation with a posterior draw during ACL reconstruction did not result in significantly better postoperative stability. The postoperative clinical outcomes were similar between both groups.

Keywords: anterior cruciate ligament reconstruction; draw; graft.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Schematic view of (A) a posterior draw force (black arrow) applied and (B) a posterior draw force not applied during graft fixation of anterior cruciate ligament reconstruction.
Figure 2
Figure 2
Flow chart describing the patients enrolled in the study.
Figure 3
Figure 3
A femoral tunnel was formed using the transanteromedial portal method. A standard anteromedial portal was used for the viewing portal, and a far anteromedial portal was used for the working portal. The center of the anatomical footprint was marked with a microfracture awl. The femoral tunnel was formed using a cannulated reamer.
Figure 4
Figure 4
Intraoperative view of (A) a posterior draw force applied and (B) a posterior draw force not applied during anterior cruciate ligament reconstruction.
Figure 5
Figure 5
Measurement of preoperative and postoperative anterior tibial translation on anterior stress radiography. (yellow lines) Two perpendicular lines were drawn tangentially to the most posterior contour of the femoral condyle and tibial plateau. Anterior tibial translation was defined as the distance between the two perpendicular lines.
See this image and copyright information in PMC

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