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[COMPARATIVE STUDY ON CHONDRAL INJURIES VIA DIFFERENT APPROACHES TO RECONSTRUCT ANTERIOR CRUCIATE LIGAMENT USING Rigidfix FEMORAL FIXATION DEVICE].

OBJECTIVE
To compare the incidence of chondral injury using Rigidfix femoral fixation device via the anteromedial approach and the tibial tunnel approach during anterior cruciate ligament (ACL) reconstruction.


METHODS
Eighteen adult cadaver knees were divided randomly into 2 groups, 9 knees in each group. Femoral tunnel drilling and cross-pin guide insertions were performed using the Rigidfix femoral fixation device through the anteromedial approach (group A) and the tibial tunnel approach (group B). ACL reconstruction simulation was performed at 0, 10, 20, 30, 45, 60, 70, 80, and 90° in the horizontal position. The correlation between incidence of chondral injury and slope angles was analyzed, and then the incidence was compared between the 2 groups.


RESULTS
The correlation analysis indicated that the chondral injury incidence increased with the increasing of the slope angle (r = 0.611, P = 0.000; r = 0.852, P = 0.000). The incidence of chondral injury was 69.1% (56/81) and 48.1% (39/81) in groups A and B respectively, showing significant difference (χ2 = 7.356, P = 0.007). The sublevel analysis showed that the chondral injury incidence of group A (36.1%, 13/36) was significantly higher than that of group B (0) at 0-30° (χ2 = 15.864, P = 0.000), but no significant difference was found between group A (95.6%, 43/45) and group B (86.7%, 39/45) at 45-90° (P = 0.267).


CONCLUSION
It has more risk of chondral injury to use Rigidfix femoral fixation device via the anteromedial approach than the tibial tunnel approach to reconstruct ACL.