Comparative biomechanical study of the Ligament Plate® and other fixation devices in ACL reconstruction

Sim, Jae Ang; Kwak, Ji Hoon; Yang, Sang Hoon; Lee, Beom Koo

doi:10.1007/s00264-008-0653-5

Cited by 9 publications

(7 citation statements)

References 24 publications

(30 reference statements)

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“…The load to failure for the Ligament plate (1011 N) is similar to that of the EndoButton (989 N) and Transfix (1072 N), whereas higher than the BioScrew (439 N). 56 There was no observed difference in graft elongation and failure for the ligament plate was by graft rupture at the interlocking grip. 56 Interference screws readily achieve femoral outlet fixation, but the tibial side offers challenges to the outlet fixation.…”

Section: Soft Tissue: Femoral Sitementioning

confidence: 94%

“…56 There was no observed difference in graft elongation and failure for the ligament plate was by graft rupture at the interlocking grip. 56 Interference screws readily achieve femoral outlet fixation, but the tibial side offers challenges to the outlet fixation. Anatomic fixation close to the joint increases the graft stiffness and may prevent some problems associated with extracortical fixation methods such as graft stretching, graft tunnel motion (called the windshield-wiper or bungee cord effect), and ultimately the tunnel widening.…”

Section: Soft Tissue: Femoral Sitementioning

confidence: 94%

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ACL Fixation Devices

Hapa

Barber²

2009

Sports Medicine and Arthroscopy Review

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Secure graft fixation for anterior cruciate ligament reconstruction is an important goal. Optimally, graft fixation allows for an aggressive postoperative rehabilitation program with the goals of immediate full range of motion, full weight bearing, and an early return to athletic activity. Current anterior cruciate ligament reconstruction techniques advance soft tissue grafts with or without bone plugs into the joint to replace the damaged ligament. Segments of these grafts are fixed within a bone tunnel or on the periosteum at a distance from the normal ligament attachment site. The graft fixation should be secure, allow normal tendon healing, and provide the graft construct with biomechanical properties, which approach that of the native ligament. Several different fixation devices are available for anterior cruciate ligament construction.

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Section: Soft Tissue: Femoral Sitementioning

confidence: 94%

Section: Soft Tissue: Femoral Sitementioning

confidence: 94%

ACL Fixation Devices

Hapa

Barber²

2009

Sports Medicine and Arthroscopy Review

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“…This discrepancy might be due to different screws, different surgical technique or different donor age, but will remain unclear without further research. Measuring the ultimate load or the load at which the catastrophic failure occurs has been established in previous studies ( Sim et al, 2009 ; Nye et al, 2017 ; Karkosch et al, 2018 ) as the standard method for quantifying the primary stability of ACL fixation systems. Ultimate load represents a clearly identifiable and easily reproducible outcome that can be used to compare the findings of different studies and fixation systems.…”

Section: Discussionmentioning

confidence: 99%

Biomechanical evaluation of an allograft fixation system for ACL reconstruction

Benca

Knegsel²,

Caspar³

et al. 2022

Front. Bioeng. Biotechnol.

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The purpose of this study was to compare the biomechanical stability, especially graft slippage of an allograft screw and a conventional interference screw for tibial implant fixation in ACL reconstruction. Twenty-four paired human proximal tibia specimens underwent ACL reconstruction, with the graft in one specimen of each pair fixed using the allograft screw and the other using the conventional interference screw. Specimens were subjected to cyclic tensile loading until failure. The two fixation methods did not show any statistical difference in load at graft slippage (p = 0.241) or estimated mean survival until slippage onset (p = 0.061). The ultimate load and the estimated mean survival until failure were higher for the interference screw (p = 0.04, and p = 0.018, respectively). Graft displacement at ultimate load reached values of up to 7.2 (interference screw) and 11.3 mm (allograft screw). The allograft screw for implant fixation in ACL reconstruction demonstrated comparable behavior in terms of graft slippage to the interference screw but underperformed in terms of ultimate load. However, the ultimate load, occurring at progressive graft slippage, may not be considered a direct indicator of clinical failure.

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“…Commonly, stiffness is calculated from a linear portion of the load-displacement curve as the ratio of the applied load and the corresponding deformation. In the literature, the displacement of a fixation in ACL reconstruction has usually been represented by the displacement of the load frame, i.e., machine actuator displacement (e.g., [ 12 , 13 , 26 , 27 ]). However, this approach does not result in a system stiffness assigned to fixation, but rather to a series of components, including the setup, embedding, bone specimen, tendon graft, and to the implant fixation itself.…”

Section: Discussionmentioning

confidence: 99%

On Measuring Implant Fixation Stability in ACL Reconstruction

Benca

Caspar

Knegsel

et al. 2021

Sensors

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Numerous methods and devices are available for implant fixation in anterior cruciate ligament (ACL) reconstruction. Biomechanical data indicate high variability in fixation stability across different devices. This study aims to provide a better insight into measuring the structural characteristics and mechanical behavior of ACL implant fixations. Fourteen human tibial specimens with reconstructed ACLs were subjected to progressively increasing dynamic loading until failure. The motions of the tibia, the proximal and distal graft ends, as well as the testing frame and actuator, were continuously recorded via a motion tracking system. Significantly higher displacements of the machine actuator (1.0 mm at graft slippage onset, and 12.2 mm at ultimate load) were measured compared to the displacements of the proximal (0.8 and 4.3 mm, respectively) and distal graft (0.1 and 3.4 mm, respectively) ends. The displacements measured at different sites showed significant correlations. The provided data suggest significant and systematic inaccuracies in the stiffness and slippage of the fixation when using machine displacement, as commonly reported in the literature. The assessment of the distal graft displacement excludes the artifactual graft elongation, and most accurately reflects the graft slippage onset indicating clinical failure. Considering the high displacement at the ultimate load, the ultimate load could be used as a standardized variable to compare different fixation methods. However, the ultimate load alone is not sufficient to qualitatively describe fixation stability.

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Comparative biomechanical study of the Ligament Plate® and other fixation devices in ACL reconstruction

Cited by 9 publications

References 24 publications

ACL Fixation Devices

ACL Fixation Devices

Biomechanical evaluation of an allograft fixation system for ACL reconstruction

On Measuring Implant Fixation Stability in ACL Reconstruction

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