The Art of Fixation in ACL Surgery: A Comparative Review of Button, Screw, Pin, Staple, and Staple Anchor
DOI:
https://doi.org/10.63682/jns.v14i32S.7972Keywords:
anterior cruciate ligament reconstruction, button, screw, pin, stapleAbstract
Anterior cruciate ligament (ACL) reconstruction is a common procedure in orthopedic surgery, and choosing the right graft fixation method is crucial for successful outcomes. This review compares the most commonly used fixation techniques—buttons, screws, cross-pins, staples, and staple anchors—based on their biomechanical performance, clinical results, and complications. Each method has its strengths and limitations. Cross-pins offer strong fixation but come with risks like joint damage. Screws are widely used but can cause graft slippage or tunnel problems. Buttons are flexible and provide high strength but may lead to tunnel motion. Staples and staple anchors are simple, affordable options, often used as supplementary fixation or in cases with graft-tunnel mismatch. Recently, bio-enhancement techniques such as platelet-rich plasma, biomaterials, and gene therapy have shown potential to improve graft healing and reduce complications. Overall, no single fixation method is best for all patients. The choice depends on the graft type, patient condition, and surgeon preference. Understanding the properties and limitations of each technique is key to optimizing ACL reconstruction results.
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