Close-looped graft suturing improves mechanical properties of interference screw fixation in ACL reconstruction |
| |
Authors: | María Prado Belén Martín-Castilla Alejandro Espejo-Reina José Miguel Serrano-Fernández Ana Pérez-Blanca Francisco Ezquerro |
| |
Institution: | 1. Laboratorio de Biomecánica, Departamento de Ingeniería Mecánica, Escuela de Ingenierías, Universidad de Malaga, C/Pedro Ortiz Ramos, s/n., 29071, Malaga, Spain 2. Servicio de Cirugía Ortopédica y Traumatología, Hospital Clínico Universitario Virgen de la Victoria, Campus Univ. Teatinos, s/n, 29010, Malaga, Spain 3. Servicio de de Cirugía Ortopédica y Traumatología, Centro Hospitalario de Jaén, Ctra. Bailén-Motril, s/n., 23009, Jaén, Spain
|
| |
Abstract: | Purpose In anterior cruciate ligament reconstruction with looped soft-tissue grafts, an interference screw is frequently used for tibial fixation. This study compared three alternatives thought to improve the initial mechanical properties of direct bioabsorbable interference screw fixation: suturing the graft to close the loop, adding a supplementary staple, or increasing the oversize of the screw diameter relative to the bone tunnel from 1 to 2 mm. Methods Twenty-eight porcine tibiae and porcine flexor digitorum profundus tendons were randomized into four testing groups: a base fixation using 10-mm-diameter screw with open-looped graft, base fixation supplemented by an extracortical staple, base fixation but closing the looped graft by suturing its ends, and base fixation but using an 11-mm screw. Graft and bone tunnel diameters were 9 mm in all specimens. Constructs were subjected to cyclic tensile load and finally pulled to failure to determine their structural properties. Results The main mode of failure in all groups was pull-out of tendon strands after slippage past the screw. The sutured graft group displayed significantly lower residual displacement (mean value reduction: 47–67 %) and higher yield load (mean value increase: 38–54 %) than any alternative tested. No other statistical differences were found. Conclusions Suturing a soft-tissue graft to form a closed loop enhanced the initial mechanical properties of tibial fixation with a bioabsorbable interference screw in anterior cruciate ligament reconstructions using a porcine model, and thus, this may be an efficient means to help in reducing post-operative laxity and early clinical failure. No mechanical improvement was observed for an open-looped tendon graft by adding an extracortical staple to supplement the screw fixation or by increasing the oversize of the screw to tunnel diameter from 1 to 2 mm. |
| |
Keywords: | |
本文献已被 SpringerLink 等数据库收录! |
|