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Introduction The method of graft fixation is critical in anterior cruciate ligament (ACL) reconstruction surgery. Success of surgery is totally dependent on the ability of the implant to secure the graft inside the bone tunnel until complete graft integration. The principle of EndoButton is based on the cortical suspension of the graft. The Cross-Pin is based on graft expansion. The aim of this study was to evaluate the biomechanical performance of EndoButton and Bio Cross-Pin to fix the hamstring graft at femoral side of porcine knee joints and evaluate whether they are able to support of loading applied on graft during immediate post-operative tasks. Methods Fourteen ACL reconstructions were carried out in porcine femurs fixing superficial flexor tendons with Titanium EndoButton (n = 7) and with 6 × 50 mm HA/PLLA Bio Cross-Pin (n = 7). A cyclic loading test was applied with 50-250 N of tensile force at 1 Hz for 1000 cycles. The displacement was measured at 20, 100, 500 and 1000 load cycles to quantify the slippage of the graft during the test. Single-cycle load-to-failure test was performed at 50 N/mm to measure fixation strength. Results The laxity during cyclic loading and the displacement to failure during single-cycle test were lower for the Bio Cross-Pin fixation (8.21 ± 1.72 mm) than the EndoButton (11.20 ± 2.00 mm). The Bio Cross-Pin (112.22 ± 21.20 N.mm–1) was significantly stiffer than the EndoButton fixation (60.50 ±10.38 N.mm–1). There was no significant difference between Bio Cross-Pin (failure loading: 758.29 ± 188.05 N; yield loading: 713.67 ± 192.56 N) and EndoButton strength (failure loading: 672.52 ± 66.56 N; yield loading: 599.91 ± 59.64 N). Both are able to support the immediate post-operative loading applied (445 N). Conclusion The results obtained in this experiment indicate that the Bio Cross-Pin technique promote stiffer fixation during cyclic loading as compared with EndoButton. Both techniques are able to support the immediate post-operative loading applied.

Gang Ye, Chao-An Peng, Hua-Bin Sun, Jing Xiao, Kang Zhu Department of Orthopedics, the People’s Hospital of Huangpi District, Wuhan City, People’s Republic of China Background: The aim of this study was to evaluate the therapeutic effect of autogenous semitendinosus graft and endobutton technique, and compare with hook plate in treatment of Rockwood type III acromioclavicular (AC) joint dislocation.Methods: From April 2012 to April 2013, we treated 46 patients with Rockwood type III AC joint dislocation. Patients were randomly divided into two groups: Group A was treated using a hook plate and Group B with autogenous semitendinosus graft and endobutton technique. All participants were followed up for 12 months. Radiographic examinations were performed every 2 months postoperatively, and clinical evaluation was performed using the Constant–Murley score at the last follow-up.Results: Results indicated that patients in Group B showed higher mean scores (90.3±5.4) than Group A (80.4±11.5) in terms of Constant–Murley score (P=0.001). Group B patients scored higher in terms of pain (P=0.002), activities (P=0.02), range of motion (P

Bei der Kreuzbandrekonstruktion mittels Hamstring-Transplantat ist die femorale starre extrakortikale Endobutton-Fixierung weit verbreitet. Allerdings können intraoperative Anwendungsprobleme auftreten und postoperativ longitudinale Transplantatbewegungen im Fixationskanal die Einheilung beeinträchtigen. Zur Optimierung dieser Fixierung wurde eine dynamische Endobutton-Fixierung entwickelt. In einem standardisierten Modell wurde die Primärstabilität von verschiedenen dynamischen Endobutton-Fixierungen untersucht. Jedes Konstrukt wurde zunächst zyklisch und anschließend bis zum Versagen belastet und dabei die Ausreißkraft, Steifigkeit und Elongation ermittelt. Eine dieser dynamischen Fixierungen erreichte eine mindestens vergleichbare Stabilität wie die konventionelle Endobutton-Fixierung. Dies ermöglicht eine Verbesserung der klinischen Handhabung, eine bessere Positionierung des Sehnentransplantates und eine Verkürzung des Fadenmaterials, welche eine Stabilitätssteigerung bewirkt.

Background: One of the most common orthopedic clinic visits involves direct and indirect knee trauma leading to rupture of anterior cruciate ligament (ACL). Endobutton and Rigidfix are most frequent treating methods that used by orthopedic surgeons. Thus the aim of this study was compare the clinical results of reconstructing arthroscopic ACL of the knee through two methods namely Rigidfix and Endobutton. Materials and Methods: In a clinical trial study, a total of 40 patients with rupture of ACL were selected and randomly divided into two groups. The groups were treated through fixation procedures either Endobutton or Rigidfix. Prior to surgery and then at least 2 years after surgery, the patients were under physical examination in terms of knee range of motion, knee stability, knee pain, ability to perform daily activities and exercises and compared between the two groups. Results: The knee range of motion in Endobutton and Rigidfix were 135.73 ± 2.63 and 129.87 ± 7.14° resprectively (P = 0.06). comparing two groups, during last month in Endobutton and Rigidfix the frequency of knee pain were 2.5 ± 1.4 and 3.4 ± 1.4 respectively (P = 0.08). Moreover, the pain intensity score were 2.9 ± 1.5 and 2.6 ± 1.1 (P = 0.49). But there was a significant difference observed in patients' satisfaction and ability to perform sports activities. Conclusions: The two fixation methods namely Endobutton and Rigidfix are not preferred over one another. But patients' satisfaction and ability to perform sports activities in Endobutton was better than the Rigidfix.

Background: Although numerous suture-button fixation techniques for acromioclavicular (AC) joint reconstruction have been validated with biomechanical testing in the superior direction, clinical reports continue to demonstrate high rates of construct slippage and breakage. Purpose: To compare the stability of a novel closed-loop double Endobutton construct with a commercially available cortical button system in both the axial and superior directions. Study Design: Controlled laboratory study. Methods: Six matched pairs of fresh-frozen cadaveric upper extremities were anatomically dissected and prepared to simulate a complete AC joint dislocation. One side of each pair was reconstructed with the double Endobutton (DE) construct and other side with the dog bone button (DB) construct. The specimens were then tested using a materials testing machine, determining initial superior and axial displacements with a preload, and then cyclically loaded in the axial direction with 70 N for 5000 cycles. Displacement was again measured with the same preloads at fixed cycle intervals. The specimens were then loaded superiorly to failure. Results: At 5000 cycles, the mean axial displacement was 1.7 mm for the DB group and 1.2 mm for the DE group ( P = .19), and the mean superior displacement was 1.1 mm for the DB group and 0.7 mm for the DE group ( P = .32). Load at failure was similar (558 N for DE, 552 N for DB; P = .96). There was no statistically significant difference in the modes of failure. Conclusion: Biomechanical testing of both constructs showed similar fixation stability after cyclical axial loading and similar loads to failure. Clinical Relevance: The strength of both constructs after cyclical loading in the axial plane and load-to-failure testing in the superior plane validate their continued clinical use for achieving stability in AC joint reconstruction procedures.

PubMedID: 24095235 Background: Minimally invasive Q3 repair has been proposed for acute Achilles tendon rupture with low rate of complications. However there are still controversies about optimal technique. In this study we aimed to describe Endobutton-assisted modified Bunnell configuration as a new Achilles tendon repair technique and evaluate its biomechanical properties comparing with native tendon and Krackow technique. Methods: 27 ovine Achilles tendons were obtained and randomly placed into 3 groups with 9 specimens ineach. The Achilles tendons were repaired with Endobutton-assisted modified Bunnell technique in group 1, Krackow suture technique in group 2 and group 3 was defined as the control group including native tendons. Unidirectional tensile loading to failure was performed at 25. mm/min. Biomechanicalproperties such as peak force to failure (N), stress at peak (MPa), elongation at failure, and Young'smodulus (GPa) was measured for each group. All groups were compared with each other using one-wayANOVA followed by the Tukey HSD multiple comparison test (a. = 0.05). Results: The average peak force (N) to failure of group 1 and group 2 and control group was 415.6. ±. 57.6, 268.1. ±. 65.2 and 704.5. ±. 85.8, respectively. There was no statistically significant difference between native tendon and group 1 for the amount elongation at failure (p. >. 0.05). Conclusions: Regarding the results, we concluded that Endobutton-assisted modified Bunnell technique provides stronger fixation than conventional techniques. It may allow early range of motion and can be easily applied in minimally invasive and percutaneous methods particularly for cases with poor quality tendon at the distal part of rupture. Level of evidence: Level II, Biomechanical research study. © 2013 European Foot and Ankle Society.

Objective: The aim of this study was to compare the effects of Endobutton post-fixation and femoral (TransFix) transfixation in ACL reconstruction on lower extremity muscle strength, joint position sense, and knee stability.Methods: Subjects who had undergone ACL reconstruction with hamstring tendon using Endobutton post-fixation (n=20, mean age: 26.5 years) or femoral transfixation (n=20, mean age: 29.9 years) were recruited to an ACL rehabilitation program. Twelve months after surgery, quadriceps and hamstring torque values were recorded using an isokinetic dynamometer. Computerized coordination and proprioception tests (Functional Squat System; Monitored Rehab System) were performed to determine the deficits in joint position sense. The anterior translation test was performed using a Kneelax 3 arthrometer to determine knee laxity.Results: Side-to-side differences between groups for hamstring and quadriceps muscle strength, concentric and eccentric motor coordination and anterior tibial laxity were not significantly different (p>0.05).Conclusion: No statistically significant differences in functional outcome were found 1 year after the ACL reconstruction using Endobutton post-fixation and femoral transfixation with hamstring tendon graft. Deficits in hamstring-quadriceps muscle strength, motor coordination and proprioception were still found in both groups. We therefore recommend that long-term followup and rehabilitation including neuromuscular exercises should be continued for longer than one year after ACL reconstruction., Amaç: Çalışmamızda Endobutton postfiksasyon ve femoral transfiksasyon yöntemleri kullanılarak ön çapraz bağ (ÖÇB) rekonstrüksiyonu yapılan kişilerin, alt ekstremite kas kuvveti, eklem pozisyon hissi ve diz stabilitesi sonuçlarını karşılaştırmayı amaçladık. Çalışma planı: Hamstring tendon grefti kullanılarak Endobutton postfiksasyon (n=20; ortalama yaş: 26.5) ve femoral transfiksasyon (n=20; ortalama yaş: 29.9) yöntemleri ile ameliyat edilmiş bireyler klinik ÖÇB rehabilitasyon programına alındı. Ameliyat sonrası 12. ayda izokinetik dinamometre ile kas testi yapılarak, kuadriseps ve hamstring kas kuvvetleri değerlendirildi. Diz eklemi pozisyon hissi kayıplarını belirlemek için bilgisayarlı koordinasyon ve propriosepsiyon testleri (Functional Squat System; Monitored Rehab System) yapıldı. Diz laksitesini belirlemek için ön çekmece testi, Kneelax 3 artrometre kullanılarak yapıldı. Bulgular: İki grup arasında hamstring ve kuadriseps kas kuvvetleri, konsantrik ve egzantrik motor koordinasyon ve ön tibial laksite parametrelerinde istatistiksel açıdan anlamlı bir fark bulunmadı (p>0.05). Çıkarımlar: Çalışmamız femoral transfiksasyon ve Endobutton postfiksasyon cerrahi tekniği ile ÖÇB rekonstrüksiyonu yapılan bireylerin ameliyat sonrası 1. yıl itibarıyla fonksiyonel sonuçları arasında istatistiksel açıdan anlamlı bir fark olmadığını göstermiştir. Ancak her iki grupta da hamstring-kuadriseps kas kuvveti, motor koordinasyon ve propriosepsiyon yetersizliği devam etmektedir. Bu yüzden nöromusküler egzersizler içeren rehabilitasyon programı ve takibin, cerrahi sonrası 1 yıldan az sürmeyecek şekilde devam etmesini tavsiye etmekteyiz.

Studienziel: Die Ruptur des vorderen Kreuzbandes gehört zu den häufigsten Bandverletzungen des Menschen im jungen Alter. Aufgrund der hohen Inzidenz und der damit einhergehenden funktionellen Einschränkungen besteht ein anhaltendes Interesse an der Verbesserung bestehender bzw. Entwicklung neuer, besserer Techniken zur Rekonstruktion dieses kniestabilisierenden Bandes mit autologen Sehnen. Die stabile und biologisch verträgliche Verankerung des Sehnentransplantates stellt einen der wichtigsten Aspekte für die erfolgreiche Transplantateinheilung dar. Im Rahmen einer prospektiven Fallgruppenanalyse wurde ein Vergleich zwischen einer transversalen Pin-Fixation und einer extrakortikalen Anker-Fixation mit Hamstrings angestellt.Material & Methoden: 67 Personen, mit einem mittleren Operationsalter von 33 Jahren wurden in eine prospektive Studie eingeschlossen und präoperativ klinisch sowie nach 6 und 12 Monaten postoperativ klinisch und kernspintomographisch untersucht. Alle Patienten erhielten eine autologe Sehnenplastik aus Hamstringsehnen. In einer Gruppe (21 Fälle) wurde der EB als Vertreter der gelenkfernen extrakortikalen Verankerung gewählt. In der zweiten Gruppe (46 Fälle) wurde eine gelenknahe Fixation mittels RF angewendet. Untersucht wurden folgende Aspekte:1.) Klinische Untersuchungen: KT-1000-Messung, Lachmann-Test, Pivot-Shift-Test, Neutral-Null-Methode.2.) Klinische Scores: IKDC-Score, Lysholm-Score, Tegner-Score, Meyers-Score.3.) Kernspintomographie: Reflux, Knochenmarksödem ( bone bruise ), Kniegelenkserguss, Signalintensitäten der Bohrkanäle, Knochenkanalerweiterung ("tunnel widening" = TW).Ergebnisse: Bei den klinischen Nachuntersuchungen zeigte die RF-Gruppe höhere Stabilitätswerte nach 6 Monaten (t6) in der KT-1000-Messung. Dies relativierte sich jedoch nach 12 Monaten (t12) wieder, wonach kein signifikanter Unterschied mehr zwischen den Gruppen bestand.Die subjektive Zufriedenheit der Patienten und damit die durchgeführten klinischen Scores zeigten für beide Gruppen vergleichbare Werte zu beiden Zeitpunkten (p=0.589).Die gemessenen kernspintomographischen Parameter unterschieden sich zu frühen Zeitpunkten leicht. In der Kategorie "femoraler Reflux" zeigten sich in der EB Gruppe zum t6 geringe Säume , die sich aber zum t12 in keinen Reflux zu der RF Gruppe anglichen. Tibial zeigte sich in beiden Gruppen zu beiden Zeitpunkten kein Reflux .Es zeigte sich in keiner der beiden Gruppen ein TW. Diskussion: Die Vertreter zweier unterschiedlicher Fixationstechniken zeigten im 12monatigen Zeitverlauf keinen wesentlichen Unterschied bei klinischen und MRT radiologischen Ergebnissen. Diskrete Unterschiede im Reflux von Synovialflüssigkeit und KT- 1000 Stabilität zum t6 weisen auf einen unterschiedlichen Einheilungsverlauf in der frühen Phase hin. Nach 12 Monaten gab es anhand der gemessenen Werte jedoch keinen Anhalt mehr auf eine unterschiedliche Integration der Transplantate. Beide Verfahren zeigen sichere Verläufe und erfolgreiche Ergebnisse bei unterschiedlichen Verankerungstechniken. Die Ergebnisse weisen auch darauf hin, dass eine gelenkferne Verankerung alleine nicht für das Auftreten eines TW verantwortlich gemacht werden kann., Aim: Anterior cruciate ligament rupture in young people is a common clinical presentation showing a high incidence and resulting in loss of function and disability. A stable and biological compatible fastening of a tendon graft in ACL reconstruction is a challenge for transplant fixations and causes the success of the tendon graft integration a lot. Within a prospective case group study, two hamstring fixation techniques, a pin fixation with RigidFix® (RF) and an anchor fixation with EndoButton (EB) were compared. Method: 67 patients in the mean age of 33 years were included to the study group. Two series of patients were compared: Both groups underwent a preoperative clinical evaluation; a follow-up including a clinical re-evaluation and a MRI was performed after 6 and 12 months after surgery. All patients had received an autologous quadrupled semitendinosus and gracilis graft. In one group (N=21) EB was used for representing an ab-articular graft fixation. The second group (N=46) with RF was used to represent the juxta-articular fixation. Objective measurements for outcome were chosen: 1.) Clinically: KT-1000-arthrometric stability testing, Lachmann-test, Pivot-Shift-test, range of motion, 2.) Scores: IKDC-score, Lysholm-score, Tegner-score, Meyers-score, 3.) MRI: Reflux, bone bruise, knee joint swelling, signal intensity in the tunnel. Special interest was focused in the question of tunnel widening.Results: The KT-1000 values for clinical outcome were slightly more stabile at t6 in the RF group but equalized later at t12.Clinical scores and thereby the subjective impression of the patients showed comparable results for both groups at t6 and t12 (p=0.589).The results from MRI showed moderate differences between both groups in the early phases. The category femoral reflux showed slight minimal fringe in the EB group at t6 but aglined to no reflux together with the RF group at t12. The median for tibial reflux was stable for both groups at both times ( no reflux ). Tunnel widening was not detectable in neither of the groups. Conclusions: The substitutes of both different fixation techniques showed no significant differences in clinical scores, clinical outcome and MRI results in a 12-month time course. Discrete varieties in the reflux rate and KT-1000 stability at t6 point at differences in the early integration process. The was no more indication of a different integration after 12 month from the measured values. Both procedures demonstrate to be safe and successful fixation techniques. The results also indicate that an abarticular graft fixation may not alone be responsible for tunnel widening.

The ideal treatment for acute acromioclavicular joint dislocation is still controversial, both in terms of indications and surgical technique. The clinical and radiographic outcomes of 16 patients affected by acute AC joint dislocation (type III-V) and arthroscopically treated with a coracoclavicular double flip button are presented. Despite the excellent clinical results both in terms of Constant score (mean 97 points) and patient satisfaction, at a mean follow-up of 31 months the radiographs showed partial loss of reduction due to distal migration of the flip button within the upper third of the clavicle in one-fourth of the cases. The technique presented here proved to be safe and minimally invasive while delivering good aesthetic results and allowing for the treatment of associated lesions. Furthermore, the technique could benefit from more advanced retention devices, which ought to reduce or avoid migration of the flip buttons.

In der vorliegenden Arbeit wurden 2-Jahres Nachuntersuchungsergebnisse von 81 Patienten dargestellt, die sich einer vorderen Kreuzbandplastik mit autologer Semitendinosussehne und EndoButton™-Fixationstechnik unterzogen hatten. Es handelte sich um 20 Patientinnen und 61 Patienten, die im Mittel 30,2 Jahre alt waren. Der Zeitpunkt der Nachuntersuchung lag zwischen 24 und 30 Monaten, im Mittel waren es 28,5 Monate. Hinsichtlich der Kriterien für den Operationserfolg – Bandstabilität (75,5% negativer Lachman-Test, 71,7% negative vordere Schublade, KT-1000-Arthrometer: 70% 0-3 mm Dehnung), subjektive Zufriedenheit (86,4% ’guter’/’sehr guter’ Lysholm-Score, 82,7% Schmerzfreiheit), Aktivitätslevel (Median-Minderung beim Tegner-Aktivitätsscore: präoperativ 7 Punkte, postoperativ 6 Punkte), sowie Funktionalität (88,6% ’normale’/’fast normale’ IKDC-Score-Bewertung, 92,4% ’guter’/’sehr guter’ OAK-Score) – wurden überwiegend gute und sehr gute Ergebnisse erzielt. Das Vorhandensein etwaiger Zusatzverletzungen wirkte sich in unserer Untersuchung nicht signifikant negativ auf die Scores aus. Die Verankerungstechnik mit einem Kippanker (EndoButton™), der außerhalb des Bohrkanales liegt, erlaubt durch eine größere Kontaktfläche eine gute Integration (Ligamentisation) des Transplantates. Als distale Fixation haben sich gegenüber Schrauben mittlerweile knopfartige Anker durchgesetzt, die noch weniger traumatisierend sind. Bei guten subjektiven, wie objektiven Untersuchungsergebnissen konnten die meist sportlich aktiven Patienten zwei Jahre postoperativ schmerzfrei sein und einen besseren oder zumindest gleich guten Aktivitätslevel wie in der Zeit vor der Operation erreichen. Vergleicht man die präsentierten Ergebnisse mit denen anderer Autoren, kann die dreifach-gelegte Semitendinosussehnenplastik mit EndoButton™-Fixation als gleichwertige und komplikationsarme Alternative zur Patellarsehnenplastik charakterisiert werden. In this study we presented two-year follow-up results of 81 patients, who underwent anterior cruciate ligament reconstruction with semitendinosus autograft and EndoButton™ fixation technique. We included 20 women and 61 men, who were on the average 30,2 years old,. The follow-up examinations were performed on average after 28,5 months, ranging from 24 to 30 months. Concerning the criteria for operative success – stability of the graft (75,5% negative Lachman-test, 71,7% negative anterior-posterior translation, KT-1000 arthrometer: 70% elongation between 0-3 mm), subjective assessment (86,4% ‘excellent’ and ‘good’ Lysholm score, 82,7% free of pain), activity level (decrease of median of Tegner activity score: preoperative 7 points, postoperative 6 points) and functionality (88,6% ‘normal’ and ‘nearly normal’ IKDC-group-grade, 92,4% ‘good’ and ‘excellent’ OAK score) – mostly good and excellent results were achieved. In our examination the presence of associated injuries did not influence the results in a significantly negative way. The fixation device (EndoButton™), which comes to lay outside the drilling tunnel, influenced the integration process (ligamentization) in a positive way, because of an extended contact area. Meanwhile special anchors are also used for the tibial fixation of the graft, as they are even less traumatizing. Two years after the reconstruction surgery, achieving good subjective and objective evaluations, our mostly sportive active patients were free of pain and they obtained a better or a least equal activity level compared with the pretraumatic period. Comparing the presented results with those of other authors the tripled semitendinosus tendon autograft with EndoButton™ fixation can be considered as an equivalent alternative with a low complication rate to the patellar tendon autograft.

Das Ziel dieser Arbeit ist die Überprüfung des Stabilitätsgewinnes infolge einer operativen Therapie des rupturierten vorderen Kreuzbandes mit einer ipsilateralen autogenen, femoral mit einem Endobutton fixierten, Semitendinosussehne als Dreifachschlinge bei 103 Patienten, die in der Zeit vom Juli 1993 bis zum Januar 1995 an der Orthopädischen Klinik der Justus-Liebig-Universität in Gießen operiert wurden. Des weiteren sollten im Rahmen dieser Arbeit geschlechtsspezifische Unterschiede, Unterschiede in der akuten bzw. chronischen Versorgung der Ruptur sowie bezüglich der Compliance der Patienten im Hinblick auf die erzielte Stabilität ermittelt werden. Darüberhinaus sollte der Frage nachgegangen werden, inwieweit die Patienten auf ihr ursprüngliches, prätraumatisches bzw. präoperatives sportliches Aktivitätsniveau zurückkehren konnten. Im Rahmen dieser prospektiven Studie wurden an fünf verschiedenen Untersuchungsterminen (präoperativ, 6 Wochen p.o., 3 Monate p.o., 6 Monate p.o., 12 Monate p.o.) umfangreiche klinische Untersuchungen sowie jeweils ausführliche systematische Befragungen der Patienten durchgeführt. Zu den durchgeführten klinischen Untersuchungen gehörten der vordere Schubladentest, der Lachmann-Test sowie die Anschlagsqualität beim Lachmann-Test, KT-1000-Arthrometer-Messungen, Pivot-Shift-Zeichen, Seitenbandstabilität, Beinumfangsmessungen, Muskelfunktionstests und Bewegungsdefizite. Neben röntgenologischen Befunden wurden des weiteren systematische Befragungen zur subjektiven Beurteilung des Stabilitätsgewinnes und dem Auftreten von Schmerzen und Schwellungen herangezogen. Zur Klassifizierung der Kniegelenkstabilität und der klinischen Probleme wurden in der vorliegenden Arbeit die IKDC-Qualifikation, der Lysholm-Score und der OAK-Score ausgewählt. Die körperliche Aktivität der Patienten wurde mit dem Aktivitätsscore nach Tegner und Lysholm dokumentiert. Zwölf Monate nach der Operation wurden die Patienten zusätzlich zu postoperativen Komplikationen sowie der Compliance befragt. Die Ergebnisse des vorderen Schubladentests zeigen nach zwölf Monaten p.o. bei 86,2 % der Patienten ein negatives und somit normales Ergebnis der vorderen Kniestabilität. Ähnliche Ergebnisse liefert der Lachmann-Test sowie dessen Anschlagsqualität mit 81,6 bzw. 96,6 % der Patienten, die zwölf Monate p.o. eine normale Kniestabilität aufweisen. Die metrische vordere Translation der KT-1000-Arthrometer-Messungen lag präoperativ deutlich über, im weiteren Verlauf jedoch stets unter dem Normwert von 3,0 mm. Der ermittelte Compliance Index lag präoperativ im Mittel deutlich über dem Normwert von 1,0 mm, im weiteren Beobachtungszeitraum jedoch stets darunter. Während in Bezug auf den Compliance Index bei den Männern signifikant höhere Werte als bei den Frauen nachgewiesen werden können, zeigen sich beim MMD keine signifikanten Unterschiede zwischen Männern und Frauen. Tendenziell liegen jedoch auch beim MMD die Werte der Männer über denen der Frauen. Die Ergebnisse der KT-1000-Arthrometer-Messung zeigen in der vorliegenden Untersuchung keine Unterschiede in der erzielten Stabilität des Kniegelenkes in Abhängigkeit vom Operationszeitpunkt. Das Ausmaß der Flexionsdefizite steigt tendenziell mit zunehmender Dauer zwischen Ruptur und Operationszeitpunkt an, es können jedoch weder hinsichtlich der Flexions- noch der Extensionsdefizite signifikante Unterschiede in Abhängigkeit vom Operationszeitpunkt nachgewiesen werden. Prätraumatisch wies das untersuchte Patientenkollektiv einen mittleren Tegner-Activity-Level von 7,2 auf. Unmittelbar präoperativ sank dieser Wert auf 2,7. Zwölf Monate p.o. wurde ein Wert von 6,0 ermittelt. Um zu überprüfen, ob sich die Stabilität, die Beinumfangsdifferenzen und die Bewegungsfreiheit des operierten Kniegelenks in Abhängigkeit von der Compliance der Patienten unterscheiden, wurde der H-Test nach Kruskal-Wallis durchgeführt. Die Ergebnisse zeigen signifikante Unterschiede in Bezug auf die KT-1000-Arthrometer-Messung und die Extensionsdefizite in Abhängigkeit von der Compliance der Patienten, während bei den Flexionsdefiziten und Beinumfangsdifferenzen keine Unterschiede nachgewiesen werden können. Auffällig ist, dass die Gruppe mit einer nur mäßigen Compliance die niedrigsten KT-1000 MMD-Werte aufweist. Durch die vorliegende Studie konnte gezeigt werden, dass die angewandte Operationsmethode und das gewählte Implantat in dem evaluierten kurzfristigen Nachuntersuchungszeitraum keine zur Änderung des Therapieverfahrens führenden Schwächen boten. Insgesamt zeigten sich aufgrund der erzielten vorderen Kniegelenksstabilität, der subjektiven Zufriedenheit der Patienten und der geringen Komplikationsrate sehr zufriedenstellende Ergebnisse. Weitere, mittel- und langfristige Nachuntersuchungen sind notwendig, um die Zuverlässigkeit des gewählten Operationsverfahrens abzusichern., The aim of this study was the evaluation of knee ligament stability in patients status post anterior cruciate ligament reconstruction (ACL). ACL reconstruction was performed with endobutton fixation of ipsilateral autogenous tripleloop tendon of musculus semitendinosus. Operations have been conducted between July 1993 and January 1995 in the orthopedic department of Justus-Liebig-University in Giessen, Germany. Furthermore sex specific differences, differences in acute or chronic ACL reconstruction, compliance of patients with regard to post operative knee stability as well as comparison between retraumatic and post operative levels of activity have been determined. For evaluation clinical examinations as well as interviews have been carried out on five different appointments: preoperative, 6 weeks postoperative, 3 month postoperative, 6 month postoperative and 12 month postoperative. Clinical examinations included front drawer test, Lachman test, KT-1000-Arthrometer-Measurements (MMD and CI), Pivot shift test, ligament laxity evaluation, measurement of leg circumference, muscle tests and determination of range of motion. Besides analyses of x-rays interviews concerning postoperative stability, pain and swelling have been done. IKDC-Qualifikation, Lysholm-score and OAK-score were used for classification of knee stability. Physical activity was documented using the activity score by Tegner and Lysholm. Patients were interviewed regarding postoperative complications 12 month after ACL reconstruction. The front drawer test was negative in 86.2 % of the patients 12 month postoperative, demonstrating normal anterior knee stability. Comparable results could be shown with 81.6 % for Lachman test and 96.6 % in impact quality for this test. With KT-1000-Arthrometer-Measurements anterior translation movement (MMD) was preoperative higher than the cut-off-value of 3.0 mm. However, postoperative it was in every case below this cut-off-value. Preoperative CI was higher than the cut-off-value of 1.0 mm. Postoperative it was in every case lower than the above mentioned value. Regarding the MMD significant differences between males and females could not be shown. Nevertheless MMD-values for men were slightly higher compared to women. KT-1000-Arthrometer-Measurements did not show any differences regarding time of operational intervention. Flexion deficiency increases slightly with increasing time between ACL-ruptur and ACL-reconstruction, but no significant differences could be shown. The average Tegner-Activity-Level was 7.2 pretraumatic, 2.7 preoperative, and 6.0 twelve month postoperative, respectively. KT-1000-Arthrometer-Measurements as well as extension deficiencies showed significant differences depending on the compliance of the patients. Patients with moderate compliance showed the lowest MMD-values. This study shows that the applied method of ACL reconstruction in combination with the chosen implant has proven its value. Very satisfactory results could be shown demonstrated by anterior knee stability, patients satisfaction and low rate of complications. In the future follow-up examinations should be conducted to evaluate the reliability of the described method of ACL reconstruction.