Making Sure Your ACLs are All Buttoned Up

A large and convincing case series shows the way.

Making Sure Your ACLs are All Buttoned Up

What’s the Claim?

A simple but large case series of ACL reconstructions using cortical suspensory fixation devices (button fixation) on the femoral side found:

  • 3.5% of knees had malpositioned buttons (42 of 1213)
  • Of those, 17% underwent immediate revision and 29% ultimately were revised
  • The risk of button malposition was lower in knees where intraoperative fluoroscopy or direct open visualization were used to confirm button placement, compared to arthroscopic visualization or passing the button through the skin
    • Risk of malposition fell to 0% for fluoroscopy and open visualization, and about 5% each for the latter two approaches (p <0.05).

How’s It Stack Up?