A randomized prospective controlled study with 5-year follow-up of cross-pin femoral fixation versus metal interference screw fixation in anterior cruciate ligament reconstruction

Purpose The purpose of this study was to determine and compare mid- to long-term results of cross-pin versus metal interference screw fixation of ACL graft. Methods In a prospective trial, 62 patients were randomized into two groups based on method of fixation. Transtibial drilling technique was used in the cross-pin and outside-in femoral drilling in the interference screw fixation group. Clinical and radiographical outcomes were assessed 2 and 5 years postoperatively. Results The study showed no clinically significant difference with respect to method of graft fixation. Mean anteroposterior side-to-side instrumented laxity difference was 2.4 mm in the cross-pin group and 2.5 mm in the screw group (n.s.). Median Tegner and mean Lysholm scores at 5 years were 6 (range 3–9) and 92.2 (range 69–100) in the screw group and 7 (3–10) and 93.3 (82–100), respectively, in the cross-pin group. Radiographical osteoarthritis increased in both groups from 2 to 5 years after reconstruction ( p