Comparison of the effects of endobutton continuous loop and adjustable zip loop devices on bone tunnel enlargement and clinical results in arthroscopic anterior cruciate ligament reconstruction: A retrospective observational study

It was aimed to reveal the effects of 2 different techniques [Endobutton Continuous Loop (CL), ZipLoop technique] used for graft fixation in anterior cruciate ligament (ACL) reconstruction on bone tunnel enlargement and clinical results. Patients who underwent arthroscopic ACL reconstruction using hamstring tendon graft due to ACL rupture between January 2016 and December 2020 were retrospectively analyzed. The study included 80 patients who were operated on by the same surgical team in the same clinic. Forty patients who underwent repair using the suspension system ZipLoop technique were classified as Group 1, and 40 patients who underwent repair using the Endobutton CL technique were classified as Group 2. Plain radiography and MRI were used to evaluate bone tunnel widening. Visual analog scale (VAS), International Knee Documentation Committee (IKDC) knee assessment score, and Lysholm scores were evaluated at the last follow-up to evaluate clinical outcomes. When bone tunnel enlargement was evaluated between the groups, femoral and tibial tunnel enlargement was found to be greater and statistically significant in Group 2 patients in direct radiography measurements. No statistically significant difference was found in tunnel enlargement in MRI measurements (P > .05). However, in MRI measurements, the graft apex-tunnel apex distance was found to be greater and statistically significant in Group 2 patients (P < .05). When the clinical results of both groups were compared, no statistically significant difference was found in VAS, IKDC and Lsyholm scores (P > .05). The graft fixation method affects bone tunnel enlargement. However, it was observed that this had no effect on clinical results.