press-fit femoral fixation in acl reconstruction using bone-patellar tendon-bone graft

bone-patellar tendon auto graft is probably the most widely used graft for acl reconstruction. several methods for graft fixation have been described. to avoid intra-articular hardware we adopt biological fixation with a femoral trapezoidal press-fit fixation. a prospective study was performed on 30 consecutive active people who underwent acl reconstruction with this technique by two surgeons between september2004 and march2007 (mean follow-up 15.2 months). results were evaluated by an independent examiner using radiography, subjective and objective evaluation. assessment using the ikdc knee scoring revealed 92% of the patients with a normal or nearly normal knee joint. lysholm's score was 63.6(40- 86) preoperatively and 91.88(73-100) at the latest follow up (p < 0.005). no patient complained of instability at latest follow up. the quadriceps muscle showed mild atrophy at 3 and 6 months and at final follow-up. five patients complained of anterior knee pain and had a positive kneeling test. we found no graft displacement on follow up radiographs. all cases showed radiological evidence of graft osteointegration at last follow up. our results show that press-fit fixation of trapezoidal bone graft in femoral tunnel is a simple, reliable, and cost-effective alternative for acl recon-struction using bone-patellar tendon-bone graft.