皮质骨嵌压钉在前交叉韧带重建中的生物力学研究

目的探讨胭绳肌腱移植重建前交叉韧带（ACL）胫骨端皮质骨嵌压钉的生物力学。方法新鲜冷冻膝关节标本21具（北京市解剖学会提供），采用四股胭绳肌腱移植重建ACL，胫骨端分别用自制皮质骨嵌压钉（n=7）、可吸收界面螺钉（n=7）和Intrafix（n=7）固定，测试最大载荷、100N和400N位移、抗拉刚度、失败模式等数据并进行统计学分析。结果以上指标在皮质骨嵌压钉组和可吸收界面螺钉组无统计学差异。皮质骨嵌压钉组的最大拔出载荷及抗拉刚度〈Intrafix固定组（P〈0．05），100N位移、400N位移〉Intrafix固定组（P〈0．05）。结论自制皮质骨嵌压钉的最大拔出载荷、100N位移、400N位移以及抗拉刚度均与可吸收界面螺钉相近，可以满足ACL重建固定肌腱的需要。

Biomechanical evaluation of tendon graft fixation at the tibial site in anteriorcruciate ligament reconstruction with cortical press-fit bolt

Objective To evaluate the biomechanical strength at the tibial site in anterior cruciate ligament （ACL） reconstruction with cortical press-fit bolt. Methods ACL was reconstructed in 21 fresh frozen cadaver knees using four-stranded hamstring tendon graft. Specimens were divided into cortical press-fit bolt group （n=7）, bioabsorbable interference screw group （n=7）, and intrafix group （n=7）. On each sample, a load-to-failure test was performed. Ultimate failure load, stiffness, displacement of 100N and 400N, and mode of failure were recorded. Results The failure load and stiffness of cortical press-fit bolt fixation were lower than those of intrafix fixation （P〈0.05）. Displacement of 100N and 400N of cortical press-fit bolt fixation was higher than that of intrafix fixation （P〈0.05）. No statistical difference was found in cortical press-fit bolt fixation and bioabsorbable interference screw fixation （P〉0.05）. Conclusion The biomechanical strength of tendon graft fixation at the tibial site with cortical press-fit bolt and bioabsorbable interference screw is similar, and can meet the physiological demand of tendon graft fixation in ACL reconstruction.