Fixation strength of biocomposite wedge interference screw in ACL reconstruction: effect of screw length and tunnel-screw ratio. A controlled laboratory studyReportar como inadecuado




Fixation strength of biocomposite wedge interference screw in ACL reconstruction: effect of screw length and tunnel-screw ratio. A controlled laboratory study - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

BMC Musculoskeletal Disorders

, 11:139

First Online: 30 June 2010Received: 03 March 2010Accepted: 30 June 2010

Abstract

BackgroundPrimary stability of the graft is essential in anterior cruciate ligament surgery. An optimal method of fixation should be easy to insert and provide great resistance against pull-out forces.

A controlled laboratory study was designed to test the primary stability of ACL tendinous grafts in the tibial tunnel. The correlation between resistance to traction forces and the cross-section and length of the screw was studied.

MethodsThe tibial phase of ACL reconstruction was performed in forty porcine tibias using digital flexor tendons of the same animal. An 8 mm tunnel was drilled in each specimen and two looped tendons placed as graft. Specimens were divided in five groups according to the diameter and length of the screw used for fixation. Wedge interference screws were used. Longitudinal traction was applied to the graft with a Servohydraulic Fatigue System. Load and displacement were controlled and analyzed.

ResultsThe mean loads to failure for each group were 295,44 N Group 1; 9 × 23 screw, 564,05 N Group 2; 9 × 28, 614,95 N Group 3; 9 × 35, 651,14 N Group 4; 10 × 28 and 664,99 Group 5; 10 × 35. No slippage of the graft was observed in groups 3, 4 and 5. There were significant differences in the load to failure among groups ANOVA-P < 0.001.

ConclusionsLonger and wider interference screws provide better fixation in tibial ACL graft fixation. Short screws 23 mm do not achieve optimal fixation and should be implanted only with special requirements.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2474-11-139 contains supplementary material, which is available to authorized users.

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Autor: Antonio Herrera - Fernando Martínez - Daniel Iglesias - José Cegoñino - Elena Ibarz - Luis Gracia

Fuente: https://link.springer.com/







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