Year: 2026 | Month: September | Volume: 16 | Issue: 9 | Pages: 48-56
DOI: https://doi.org/10.52403/ijhsr.20260906
Comparative Analysis of the Functional Outcome of Arthroscopic Anterior Cruciate Ligament Reconstruction Using Quadrupled Hamstring Graft Fixed with Bioabsorbable Interference Screw Against Titanium Interference Screw
Ashutosh Yadav1, Pushpa2, Sachin Kumar3
1Senior Resident, Department of Orthopaedics, Maharishi Chyawan Government Medical College, Koriawas, Narnaul, Haryana, India
2Assistant Professor, Department of Anaesthesia, Maharishi Chyawan Government Medical College, Koriawas, Narnaul, Haryana, India
3Senior Resident, Department of Orthopaedic Surgery, Balrampur Hospital, Golaganj, Lucknow, Uttar Pradesh, India
Corresponding Author: Dr. Ashutosh Yadav
ABSTRACT
Background: The choice of tibial fixation device remains an important consideration in anterior cruciate ligament (ACL) reconstruction using hamstring autografts. Bioabsorbable interference screws offer potential advantages over titanium screws, although comparative clinical outcomes remain of interest. This study compared the functional and clinical outcomes of arthroscopic ACL reconstruction using a quadrupled hamstring autograft with bioabsorbable versus titanium interference screw fixation.
Methods: This prospective comparative study was conducted in the Department of Orthopaedic Surgery, Balrampur Hospital, Lucknow, over a one-year period. Fifty patients aged 18–45 years undergoing primary arthroscopic single-bundle ACL reconstruction were included and divided equally into bioabsorbable screw (n=25) and titanium screw (n=25) groups. All patients underwent quadrupled semitendinosus and gracilis hamstring autograft reconstruction with Endobutton femoral fixation and the allocated tibial interference screw. Patients were evaluated preoperatively and at 6 weeks, 12 weeks, and 6 months using the Lysholm knee score, range of motion, anterior drawer and Lachman tests, pivot shift test, extension lag, and quadriceps strength.
Results: Baseline demographic and clinical characteristics were comparable between the groups (p>0.05). Lysholm knee scores improved progressively in both groups, with good or excellent scores at 6 months in 84.0% of patients in the bioabsorbable group and 80.0% in the titanium group. Knee laxity, pivot shift positivity, range of motion, extension lag, and quadriceps weakness also improved significantly during follow-up in both groups (p<0.05). At 6 months, the overall outcome was good in 84.0% of patients in the bioabsorbable group and 88.0% in the titanium group, with no poor outcomes and no statistically significant difference between groups (p=0.6836).
Conclusion: Arthroscopic ACL reconstruction using a quadrupled hamstring autograft demonstrated substantial short-term improvement in functional and clinical outcomes with both bioabsorbable and titanium interference screw fixation. No statistically significant difference in overall functional outcome was observed between the two fixation groups at 6 months. Bioabsorbable interference screws may therefore represent a clinically viable alternative to titanium screws for tibial fixation in primary ACL reconstruction.
Key words: Anterior cruciate ligament reconstruction, bioabsorbable interference screw, titanium interference screw, quadrupled hamstring graft, Lysholm knee score