ACL Reconstruction Using a Short Hamstring Graft and Tape Locking Screw: A Biomechanical Study

Introduction: Anterior cruciate ligament (ACL) reconstruction is one of the most widely performed orthopaedic procedures in developed counties. Reconstruction using autograft soft tissue such as hamstring tendon has been the preferred choice by many for its superior strength and less donor-site morbidity over the bone-tendon-bone graft. Fixation of soft tissue graft, however, has been less than optimal, and there is some evidence to suggest it affects the function of the reconstructed knee. A newly developed soft tissue reconstruction technique using tape locking screw fixation (TLS) has demonstrated improved fixation properties in preliminary tests and good outcomes in the initial clinical application [1]. There has been no report of biomechanical assessment of this new approach. The objectives of this study are to evaluate knee joint biomechanical behaviors after quadrupled soft tissue ACL reconstruction using TLS fixation method, and compare it with the traditional Endobutton technique in match-pair cadaver model. Modifications were also made to the TLS technique to further improve its fixation strength. The modified technique was evaluated with additional cadaver testing.