COMPARISON OF OUTCOME OF ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION USING INTERFERENCE SCREW VERSUS ADJUSTABLE BUTTON SYSTEM (ABS) IN TIBIAL GRAFT FIXATION

Abstract

Background: Anterior cruciate ligament (ACL) reconstruction is a widely performed orthopedic procedure, with graft fixation playing a pivotal role in surgical success. Among the various fixation techniques, interference screw and adjustable button system (ABS) are commonly employed, but evidence comparing their outcomes in the local population remains scarce.

Objective: To compare the short-term functional outcomes of ACL reconstruction using interference screw versus adjustable button system (ABS) for tibial graft fixation.

Methods: A randomized controlled trial was conducted at the Department of Orthopedics, Khyber Teaching Hospital, Peshawar, over six months. A total of 276 patients aged 18–50 years with chronic ACL tears were randomly allocated into two groups: Group A (interference screw) and Group B (ABS), with 138 patients each. All patients underwent standard arthroscopic ACL reconstruction using autografts. Functional outcomes were assessed preoperatively and at three months postoperatively using the International Knee Documentation Committee (IKDC) scoring system. Data were analyzed using SPSS v25, and outcomes were compared using Chi-square and t-tests, with p ≤ 0.05 considered statistically significant.

Results: Group A showed significantly greater improvement in mean IKDC scores (51.9 ± 10.4) compared to Group B (45.5 ± 11.1). Significant improvement (≥50-point increase) was noted in 71% of patients in Group A versus 55% in Group B. Moderate improvement was observed in 19.6% (Group A) and 27.5% (Group B), while 2.2% in Group A and 5.8% in Group B showed no improvement.

Conclusion: Interference screw fixation resulted in superior early functional outcomes compared to ABS in ACL reconstruction. These findings suggest its preferential use for tibial graft fixation where early recovery is desired.