The fixation strength of a novel ACL soft-tissue graft fixation device compared with conventional interference screws: a biomechanical study in vitro
The fixation strength of a novel ACL soft-tissue graft fixation device compared with conventional interference screws: a biomechanical study in vitro
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DOI：
10.1007/s00167-010-1255-5
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发表时间：
2011-04-01
影响因子：
3.8
通讯作者：
Amis, Andrew A.
中科院分区：
文献类型：
--
作者：
Halewood, Camilla;Hirschmann, Michael T.;Amis, Andrew A.
使用自体腘绳肌腱重建前交叉韧带是一种既定的外科手术，但一些移植物由于固定不良而失败。本研究将新型 ACL 移植物固定装置（EZ KneeSpan）的固定与传统软组织螺纹钛干涉螺钉 (IS) 的固定进行了比较。 EZ 装置旨在提供安全固定，同时避免与使用 IS 相关的软组织移植物损伤。使用八对新鲜冷冻的人体膝盖尸体和牛指伸肌腱。在每块胫骨和股骨中放置两个隧道，并使用 EZ 装置和 IS 将移植物固定在每块骨头中。循环拉伸载荷和拉拔测试测量移植物滑移（毫米）和固定的极限强度（N）。使用非参数 Wilcoxon 符号秩检验对结果进行比较。循环加载后的移植物滑移明显较低，EZ 组股骨为 2.4 +/- A 0.1 毫米，IS 组为 9.5 +/- A 6.2 毫米；胫骨为 3.3 +/- A 1.4 毫米，而 IS 组为 17.7 +/- A 13.6 毫米。股骨 EZ 组的平均极限载荷显着高于 IS 组（769 +/- A 223 N 与 468 +/- A 60 N），但胫骨方面没有显着差异（518 +/- A 48 N 与 546 +/- A 139 N）。我们的结果表明，使用 EZ 装置对循环加载的腿筋移植物的初始固定可能优于使用 IS 的固定。 EZ KneeSpan 装置还具有与 IS 相似的胫骨和更高的股骨极限固定强度。
Anterior cruciate ligament reconstruction using autologous hamstring tendons is an established surgical procedure but some grafts fail due to poor fixation. This study compared the fixation of a new ACL graft fixation device (the EZ KneeSpan) to conventional soft-tissue threaded titanium interference screws (IS). The EZ device was designed to provide secure fixation while avoiding soft-tissue graft damage associated with use of an IS. Eight paired fresh-frozen cadaveric human knees and bovine digital extensor tendons were used. Two tunnels were placed in each tibia and femur, and grafts were fixed using the EZ device and the IS in each bone. Cyclic tensile loading and pull-out testing measured graft slippage (mm) and ultimate strength (N) of the fixation. The results were compared using the non-parametric Wilcoxon signed-rank test. Graft slippage after cyclic loading was significantly lower in the EZ group at 2.4 +/- A 0.1 mm versus 9.5 +/- A 6.2 mm for the IS group in the femur and 3.3 +/- A 1.4 mm versus 17.7 +/- A 13.6 mm in the tibia. The mean ultimate load for the femoral EZ group was significantly higher than the IS group (769 +/- A 223 N versus 468 +/- A 60 N), but they did not differ significantly in the tibia (518 +/- A 48 N versus 546 +/- A 139 N). Our results indicate that with the EZ device the initial fixation of cyclically loaded hamstring grafts could be superior to that with an IS. The EZ KneeSpan device also had similar tibial and higher femoral ultimate fixation strength than an IS.