Fixation of osteochondral fragments in the human knee using Meniscus Arrows®

The aim of this study is to compare the hold in bone of Meniscus Arrows® and Smart Nails®, followed by the report of the results of the clinical application of Meniscus Arrows® as fixation devices. First, pull-out tests were performed to analyse the holdfast of both nails in bone. Statistical analysis showed no significant difference; therefore, the thinner Meniscus Arrow® was chosen as fixation device in the patient series of two patients with a symptomatic Osteochondritis dissecans fragment and three patients with an osteochondral fracture of a femur condyle. The cartilage margins were glued with Tissuecoll®. All fragments consolidated. Second look arthroscopy in three patients showed fixed fragments with stable, congruent cartilage edges. At an average follow-up period of 5 years no pain, effusion, locking, restricted range of motion or signs of osteoarthritis were reported. Based on the results of the pull-out tests and available clinical studies, Meniscus Arrows® and Smart Nails® are both likely to perform adequately as fixation devices in the treatment of Osteochondritis dissecans and osteochondral fractures in the knee. They both provide the advantage of one stage surgery. However, based on their smaller diameter, the Meniscus Arrows® should be preferred for this indication

Comparison of bioabsorbable interference screws and posts for distal fixation in anterior cruciate ligament reconstruction

Comparison of the results of bioabsorbable interference screws and posts for hamstring graft distal fixation in ACL reconstructions are presented. The results of 20 patients with bioabsorbable screws were compared to 22 patients with posts. The assessement was based on Lysholm-Gillquist and Marshall scores and the KT-1000 device. In the study group the points gained were 38.9 in the Lysholm-Gillquist and 12.89 in the Marshall scale. The average KT-1000 difference was 2.46 mm. In the control group the points gained were 32.93 in the Lysholm-Gillquist and 11.47 in the Marshall scale. The average KT-1000 difference was 2.5 mm. There were 14 patients in the study group with interference screw problems; in 2 the implants were removed. (1) There are no differences in outcome using bioabsorbable interference screws and posts for distal fixation of hamstring ACL grafts. (2) The lack of bioabsorbtion with poly L-lactide interference screws is frequent and causes problems