A comparison of the clinical results of the adjustable loop endobutton (lift-ultrabutton) method by the fixed loop endobutton (endobutton CL) used in the arthroscopic anterior cruciate ligament reconstruction

In our clinic, when arthroscopic reconstruction of the anterior cruciate ligament (ACL) is performed, autogenous hamstring tendons are routinely used and grafts are fixed to the femur with 2 different types of endobuttons. The aim of this study is to compare the clinical results of the fixed loop endobutton (Endobutton Continuous Loop - CL) method, which is used in arthroscopic ACL reconstruction performed in our clinic, to fix the graft to the femur, and the adjustable loop endobutton (lift-ultrabutton) method. 142 patients who underwent ACL reconstruction with arthroscopic anatomic single-band method due to ACL rupture in our clinic between January 2017 and November 2018 were included in our study. Considering the fixation material used during the fixation of the hamstring autografts taken from these patients to the femur, preoperative condition and postoperative clinical results for an average of 1 year were investigated and compared. Patient information was accessed through the registry system and files used in our hospital. The current clinical situation was evaluated in the light of physical examination findings. Lysholm and Cincinnati scores and IKDC knee assessment forms were filled in for all patients at preoperative and final control examinations. The difference between the clinical results of the patients detected with different types of endobuttons was evaluated considering the ease of surgery and duration of surgery. Autogenous hamstring tendons were fixed to the femur using an adjustable loop endobutton system in 74 patients (65%) and a fixed loop endobutton system in 40 patients (35%). Additional pathology rates of the patients were compared with both methods and no statistically significant difference was found (p = 0.217). Surgical duration of the patients fixed with adjustable loop endobutton was significantly shorter (p = 0.000 <0.001) than the surgical time of the patients fixed with fixed loop endobutton. The clinical success of both methods was found to be similar and satisfactory in terms of physical examination findings, Lysholm, Cincinnati, IKDC scores and complications. The advantages of this method are that the adjustable loop endobutton method requires less calculation during surgery and the surgical time is short. However, in order to define the ideal technique, prospective randomized studies with long-term follow-up and objective evaluation with more patients with similar characteristics are needed. Keywords: Anterior cruciate ligament, Fixed Loop Endobutton, Adjustable Loop Endobutton, Ultrabutton