Correction to: Biomechanical comparisons of current suspensory fixation devices for anterior cruciate ligament reconstruction

Jin, Cheng; Paluvadi, Siddhartha Venkata; Lee, Sung-Jae; Yoo, Seung-Jin; Song, Eun-Kyoo; Seon, Jong Keun

doi:10.1007/s00264-018-3849-3

Cited by 9 publications

(6 citation statements)

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“…Adjustable‐loop femoral cortical suspension devices offer several advantages over fixed‐loop devices [14, 16], however, there are concerns about their tendency to elongate when subjected to biomechanical loading, which may compromise the effective length of the graft‐loop construct [3, 17, 25, 26]. The length of the graft and fixation device construct is critical during the first 8–12 postoperative weeks and early rehabilitation, while the graft heals.…”

Section: Discussionmentioning

confidence: 99%

“…The more recent cortical suspension adjustable‐loop devices have several advantages: (1) they are easier to use in short femoral tunnels, with placement through the antero‐medial arthroscopic portal; (2) they allow more of the femoral tunnel to be filled with graft, and shorter graft lengths can be used, as seen with tripling/quadrupling of the graft; (3) they are suitable for most tunnel sizes, eliminating the need for fixed‐loop devices with different loop sizes [9, 14, 16, 18]. However, there are concerns about the elongation of cortical suspension adjustable‐loop devices under cyclic loading post‐fixation, which relate to the button‐locking mechanism [26].…”

Section: Introductionmentioning

confidence: 99%

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Biomechanical testing of fixed and adjustable femoral cortical suspension devices for ACL reconstruction under high loads and extended cyclic loading

et al. 2020

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Purpose: To compare loop elongation after 5000 cycles, loop-elongation at failure, and load at failure of the fixedloop G-Lok device and three adjustable-loop devices (UltraButton, RigidLoop Adjustable and ProCinch RT), during testing over extended cycles under high loading. Methods: Five devices of each type were tested on a custom-built rig fixed to an Instron machine. The testing protocol had four stages: preloading, cyclic preconditioning, incremental cyclic loading and pull-to-failure. Outcome measures were loop elongation after 5000 cycles, loop-elongation at failure, and load at failure. Results: The loop elongation after 5000 cycles for G-Lok was 1.46 ± 0.25 mm, which was comparable to that of RigidLoop (1.51 ± 0.16 mm, p = 1.000) and ProCinch (1.60 ± 0.09 mm, p = 1.000). In comparison, the loop elongation for UltraButton was 2.66 ± 0.28 mm, which was significantly larger than all other devices (p = 0.048). The failure load for all devices ranged between 1455 and 2178 N. G-Lok was significantly stronger than all adjustable-loop devices (p = 0.048). The elongation at failure was largest for UltraButton (4.20 ± 0.33 mm), which was significantly greater than G-Lok (3.17 ± 0.33 mm, p = 0.048), RigidLoop (2.88 ± 0.20 mm, p = 0.048) and ProCinch (2.78 ± 0.08 mm, p = 0.048). There was no significant difference in elongation at failure for the rest of the devices. Conclusions: Our study has shown that the G-Lok fixed-loop device and the three adjustable-loop devices (UltraButton, RigidLoop Adjustable and ProCinch RT) all elongated less than 3 mm during testing over an extended number of cycles at high loads, nonetheless, the fixed loop device performed best in terms of least elongation and highest load at failure.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Biomechanical testing of fixed and adjustable femoral cortical suspension devices for ACL reconstruction under high loads and extended cyclic loading

et al. 2020

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“…Some mechanical studies that compared adjustable-loop devices and fixed-loop devices reported that the latter showed higher breaking strength and less displacement [18][19][20][21][22][23][24][25]. On the other hand, other studies difference in either parameter [26,27].…”

Section: Discussionmentioning

confidence: 99%

The improved cortical button shows better breaking strength of sutures compared with 10 original cortical button after cyclic loading

Takahashi

2020

J EXP ORTOP

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Background: Suspensory cortical buttons are widely used for fixation of reconstructed ligaments during anterior cruciate ligament (ACL) reconstruction because they have high usability and a favorable fixing force. However, it is not always easy to fix a reconstructed ACL while maintaining appropriate ligament tension. Therefore, we developed an improved cortical button that provides temporary tension until suturing is completed. Methods: Button holes of our improved EndoButton are not perpendicular to the bone surface on which the button is placed, but have an angle of 45 degrees so that the button can be temporarily fixed by applying tension to the suture. The improved EndoButton and the original EndoButton (Smith & Nephew Inc., Andover, Massachusetts) were each tied to FiberWire 5/7 metric (5 M) (manufactured by Arthrex). Ten cycles of preliminary loading (0-50 N) were applied to each suture, followed by test loading (0-250 N) for 500 or 1000 cycles. Then, a tensile test was performed at a displacement velocity of 20 mm/min. Results: The breaking strength of the sutures of the improved EndoButton were tend to higher than those of the sutures of the original EndoButton after 1000 loading cycles (p = 0.067, d = 0.883). The moduli of rigidity of the sutures of the improved EndoButton were higher than those of the sutures of the original EndoButton after 500 loading cycles (p = 0.027) and remained almost the same regardless of the number of loading cycles. Conclusion: We found that compared with the original cortical button, the improved cortical button was better able to retain suture breaking strength and modulus of rigidity, regardless of the number of load cycles.

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“…For the other set-ups, the results were close to those obtained in the study of Nye et al [21], reporting values of 682 N for the femur-ToggleLoc™-graft set-up. The pull-out performances of suspended cortical devices reported in the literature are heterogeneous and depend on the implants and protocols studied [1,3,6,9,14,15,21,23,24]. The cortical support of the device seems to enable a greater resistance to ultimate load to failure, although the prestudy could not conirm this hypothesis.…”

Section: Ultimate Load To Failurementioning

confidence: 94%

Anterior cruciate ligament reconstruction with short hamstring grafts: the choice of femoral fixation device matters in controlling overall lengthening

Pacull

Kalk

Rongièras

et al. 2021

Knee Surg Sports Traumatol Arthrosc

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PurposeThe purpose was to conduct an independent biomechanical study comparing the main types of femoral fixation adapted to short hamstring grafts in anterior cruciate ligament (ACL) reconstruction surgery and to validate their performance. Methods The ACLip ® Femoral, ToggleLoc™ Ziploop (TLZ), and Tape Locking Screw (TLS ® ) implants were tested in tension in the following three different configurations: implant alone, implant fixed on the femur without graft, and implant fixed on the femur with graft. Grafts alone were also tested. The femurs and the 4-strand semi-tendinosus grafts were derived from porcine and human models, respectively. Each set-up was subjected to the same protocol of creep (50 N for 30 s), cycling (1000 cycles between 50 and 250 N, 1 Hz), and load to failure (50 mm/min). Results A total of 93 tests were performed (30 ACLip ® , 30 TLZ, 20 TLS ® , and 13 ST4 alone). For the implants tested with femur and graft, the mean ± standard deviation (SD) overall elongation at 250 N after cycling was 5.2 ± 0.2 mm, 8.4 ± 2.1 mm, and 5.3 ± 0.8 mm, the mean ± SD ultimate load to failure was 736 ± 116 N, 830 ± 204 N, and 640 ± 242 N, and the mean ± SD stiffness at the 1000th cycle was 185 ± 15 N/mm, 172 ± 19 N/mm, and 178 ± 21 N/mm for ACLip ® , ToggleLoc™, and TLS ® devices, respectively. There was no significant difference between the implants except for post-cycling elongation between TLZ and the other two implants (p < 0.05). ConclusionThe choice of femoral fixation device plays a decisive role in controlling the overall lengthening of an ACL reconstruction using a short hamstring graft. All implants validated the specifications in terms of ultimate load to failure, the TLS ® system had, however, a low performance limit. ToggleLoc™ with adjustable loop should no longer be used on the femur side; instead the other types of fixation should be used to improve the overall elongation control.

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Correction to: Biomechanical comparisons of current suspensory fixation devices for anterior cruciate ligament reconstruction

Abstract: The original publication of this paper contains mistakes. The first author name "Jin Cheng" is changed to "Cheng Jin ".

Cited by 9 publications

References 0 publications

Biomechanical testing of fixed and adjustable femoral cortical suspension devices for ACL reconstruction under high loads and extended cyclic loading

Biomechanical testing of fixed and adjustable femoral cortical suspension devices for ACL reconstruction under high loads and extended cyclic loading

The improved cortical button shows better breaking strength of sutures compared with 10 original cortical button after cyclic loading

Anterior cruciate ligament reconstruction with short hamstring grafts: the choice of femoral fixation device matters in controlling overall lengthening

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