Biomechanical Evaluation of a Novel Application of a Fixation Device for Bone-Tendon-Bone Graft (EndoButton CL BTB) to Soft-Tissue Grafts in Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction
Biomechanical Evaluation of a Novel Application of a Fixation Device for Bone-Tendon-Bone Graft (EndoButton CL BTB) to Soft-Tissue Grafts in Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction
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DOI：
10.1016/j.arthro.2010.01.007
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发表时间：
2010-09-01
影响因子：
4.7
通讯作者：
Yasuda, Kazunori
中科院分区：
文献类型：
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作者：
Miyatake, Shin;Kondo, Eiji;Yasuda, Kazunori
目的：本生物力学研究的目的是比较连接到 EndoButton CL BTB (ECL-BTB)（Smith & Nephew Endoscopy，Andover，MA）的屈肌腱移植物的结构特性，该移植物是新开发的用于固定骨-腱-骨移植物的，与连接到 EndoButton CL (ECL)（Smith & Nephew Endoscopy）（通常用作标准固定装置）的相同移植物的结构特性。方法：将40条猪指深屈肌腱随机分为4组。在第一组和第二组中，分别将 ECL 和 ECL-BTB 连接到直径为 6 mm 的双肌腱上。在第III组和第IV组中，以相同的方式分别将ECL和ECL-BTB附着到直径为7mm的双腱上。拉伸试验是用拉伸试验机进行的。结果：I、II、III 和 IV 组肌腱装置复合材料的线性刚度（平均值 +/- SD）分别为 131.8 +/- 18.3 N/mm、109.7 +/- 14.9 N/mm、132.4 +/- 20.5 N/mm 和 123.8 +/- 10.7 N/mm。 2 路方差分析 (ANOVA) 显示 ECL 和 ECL-BTB 之间存在显着差异 (P = .0058)。关于肌腱装置复合材料的最大载荷和失效伸长率，双向方差分析显示两种固定装置之间没有显着差异。关于横截面积，2 向方差分析表明 2 个固定装置之间没有显着差异。结论：本研究表明，连接 ECL-BTB 的屈肌腱移植物的最大载荷与 ECL 相似，而 ECL-BTB 的刚度不如 ECL。临床意义：本研究表明，由于 ECL-BTB 固定技术的刚度较 ECL 装置低，患者在使用 ECL-BTB 固定技术重建前交叉韧带后的早期不应进行剧烈活动。
Purpose: The purpose of this biomechanical study was to compare the structural properties of the flexor tendon graft connected to the EndoButton CL BTB (ECL-BTB) (Smith & Nephew Endoscopy, Andover, MA), which is newly developed to fix the bone-tendon-bone graft, with those of the same graft connected to the EndoButton CL (ECL) (Smith & Nephew Endoscopy), which is commonly used as a standard fixation device. Methods: We randomly divided 40 porcine flexor digitorum profundus tendons into 4 groups. An ECL and an ECL-BTB were attached to the doubled tendon measuring 6 mm in diameter in groups I and II, respectively. An ECL and an ECL-BTB were attached to the doubled tendon measuring 7 mm in diameter in the same manner in groups III and IV, respectively. Tensile testing was performed with a tensile tester. Results: The linear stiffness of the tendon-device composite (mean +/- SD) was 131.8 +/- 18.3 N/mm, 109.7 +/- 14.9 N/mm, 132.4 +/- 20.5 N/mm, and 123.8 +/- 10.7 N/mm in groups I, II, III, and IV, respectively. The 2-way analysis of variance (ANOVA) showed a significant difference (P = .0058) between the ECL and the ECL-BTB. Concerning the maximum load and the elongation at failure of the tendon-device composite, the 2-way ANOVA showed no significant difference between the 2 fixation devices. Regarding the cross-sectional area, the 2-way ANOVA indicated no significant difference between the 2 fixation devices. Conclusions: This study has shown that the maximum load of the flexor tendon graft connected to the ECL-BTB is similar to that of the ECL whereas the stiffness of the ECL-BTB is inferior to that of the ECL. Clinical Relevance: This study has suggested that patients should not be permitted to perform vigorous activities in the early period after anterior cruciate ligament reconstruction by use of the ECL-BTB fixation technique, because of its low stiffness compared with the ECL device.