Comparison of Femoral and Tibial Pullout Forces in Bone–Patellar Tendon–Bone Anterior Cruciate Ligament Reconstructions With a New Interference Fixation Device

A new device for the fixation of anterior cruciate ligament tendon grafts

“…However, a few points need to be mentioned concerning the values obtained by other researchers. Though the expansive screw of Seitz et al [5] obtained high values for maximum load and stiffness, grafts with bone insertions were used in their tests, namely the bone-patellar tendon-bone, and this may have given rise to the high values obtained. The expansive screw of Tuompo et al [10] also uses grafts with bone insertions and the results obtained were strangely high; on making a comparison with the interference screw a value of 2113 ± 407 N is obtained for it, a figure which far exceeds all the values obtained in other studies [8,9,11,12,15].…”

“…However, for these results to be applicable in clinical practice a long-term follow-up period of evaluation is required in a large patient population [5].…”

“…However, graft-bone fixation continues to be a major cause of concern, as shown by the large number of researchers involved in its study [2][3][4][5][6][7][8][9][10][11][12][13][14][15]. A number of devices have been designed with this end in mind, as the method of surgical fixation is the major factor influencing the graft's mechanical properties in the immediate postoperative period [2].…”

“…However, during insertion into the bone tunnel screw divergence may occur [5,6], resulting in a fixation of poor quality. The screw threads can also lacerate the graft [6,18].…”

“…The operating principle is the radial expansion of some of its components, resulting in greater compression between the graft and the bone tunnel. This compression generates frictional force which improves the bone-graft fixation, a property which has been used in ACL fixation devices proposed by other researchers [5,10,13]. …”