Cross-pin femoral fixation versus metal interference screw fixation in anterior cruciate ligament reconstruction with hamstring tendons: Results of a controlled prospective randomized study with 2-year follow-up

Purpose: To determine if there is a different clinical outcome after cross-pin versus interference screw fixation in anterior cruciate ligament (ACL) reconstruction with hamstring tendons. Type of Study: Prospective randomized clinical follow-up study. Methods: Sixty-two patients were randomized into either TransFix cross-pin (Arthrex, Naples, FL) (TransFix group, n = 31) or metal interference screw femoral fixation (screw group, n = 31) in ACL reconstruction with hamstring tendons. The distal fixations were an AO screw with spiked washer post and metal interference screw. The evaluation methods were clinical examination, CA 4000 laxity (OSI, Hayward, CA), and Lido isokinetic muscle torque measurements (Lido MultiJoint II; Loredon, West Sacramento, CA) as well as International Knee Documentation Committee (IKDC), Tegner activity level, Lysholm knee, and Kujala patellofemoral scores. Results: There were no differences between the study groups preoperatively. For the 2-year follow-up, 26 patients of the TransFix group and 30 patients of the screw group were available (90%). The evaluation methods disclosed no statistical differences between the groups at the 1- or 2-year follow-up examinations. At the 2-year follow-up, 22 (85%) of the TransFix and 22 (73%) of the screw group patients were in the IKDC A or B categories. There were significantly more additional procedures postoperatively in the TransFix group owing to the removal of the tibial fixation post hardware in 15 (48%) cases. Conclusions: There were no statistically or clinically relevant differences in the results 1 or 2 years postoperatively and both techniques seemed to improve patients' performance. Level of Evidence: Level I.