Primary Anterior Cruciate Ligament Reconstruction Using a Self-adjusting, Self-locking Button. Clinical and Radiological Results After a Minimum Follow-up of 36 Months
DOI:
https://doi.org/10.63403/re.v33i2.477Keywords:
Anterior cruciate ligament, Femoral fixation, Adjustable cortical button, Clinical outcomes, TenZ®, ArthroscopyAbstract
Introduction: anterior cruciate ligament (ACL) reconstruction depends largely on the initial stability of the graft and the femoral fixation method used. Conventional adjustable systems can exhibit loop creep under cyclic loading, with a risk of loss of tension and widening of the bone tunnel.
Objectives: to evaluate the clinical and radiological outcomes obtained with the use of a self-locking, adjustable femoral button in primary ACL reconstruction with a minimum follow-up of 36 months.
Material and methods: a retrospective–prospective cohort study (Level of Evidence III) included 50 consecutive patients undergoing primary ACL reconstruction with hamstring autograft and femoral fixation using the self-locking button. Clinical outcomes (IKDC, Lysholm, Tegner), radiographic tunnel assessment, and 9-month MRI findings were analyzed over a minimum 36-month follow-up.
Results: IKDC, Lysholm, and Tegner scores improved significantly (58.2→94.8; 62.4→93.7; 3.1→6.8; p <0.001). No graft failures, complications, or tunnel widening were observed (Δ <0.3 mm). MRI confirmed complete ligamentization and bone integration in all cases. Mean time to unrestricted sports return was 8.5 months, with full functional recovery.
Conclusion: the self-locking adjustable femoral button provided stable fixation, no complications, and reproducible clinical outcomes at 36 months, supporting its reliability as an alternative to traditional fixed-loop systems.
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Copyright (c) 2026 Horacio Rivarola, Cristian Collazo, Marcos Palanconi, Marcos Meninato, Francisco Endara Urresta, Lorena Michel, Bautista Rivarola
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