Hamstring tendon fixation using interference screws: a biomechanical study in calf tibial bone

Weiler, Andreas; Hoffmann, Reinhard; Stähelin, Andreas C.; Bail, Hermann Josef; Siepe, Christoph J.; Südkamp, Norbert P.

doi:10.1016/s0749-8063(98)70117-3

Cited by 195 publications

(173 citation statements)

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“…25 Wieler et al showed in animal studies that reducing the relative motion between tendon and wall of the tunnel promotes the ingrowth of an intervening fibrous layer and bony trabeculae. 26 They used biodegradable IFS to reduce shear forces on the tendon within the tunnel. In a biomechanical study, Ishibashi et al demonstrated that graft fixation at the aperture reduces anterior tibial translation compared with extra-articular fixation techniques.…”

Section: Discussionmentioning

confidence: 99%

Comparison of tunnel widening between interference screw and suture disc fixation after ACL reconstruction using CT scan

Ahemad

Anerao

2018

Int J Res Orthop

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Background: It is important to study the cause of tunnel widening which occurs after anterior cruciate ligament (ACL) reconstruction as it may affect tendon to bone healing. Amount of tunnel enlargement that happens after different fixation methods like interference screw or suture discs needs to be compared.The objective of the study was to test the hypothesis that aperture fixation (interference screw) reduces tunnel enlargement compared to suspensory fixation (suture disc) due to reduced graft tunnel motion.Methods: 24 bone tunnel diameters in 12 patients were evaluated by CT scan postoperatively after ACL reconstruction to measure tunnel widening. Two groups were formed, one consisting of 14 tunnels fixed by interference screws (IFS) and other consisting of 10 tunnels fixed with suture disc (SD). The difference between the two groups was compared by unpaired student’s t test.Results: The mean tunnel widening in IFS group was 0.414mm while that in the SD group was 1.23mm. The difference between the means of the two groups was statistically significant (p<0.001). Conclusions: Tunnel widening phenomenon was significantly less with anatomic IFS fixation as compared to suture disc fixation probably due to reduced motion of graft within the walls of bony tunnel and consequently better graft healing.

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Section: Discussionmentioning

confidence: 99%

Comparison of tunnel widening between interference screw and suture disc fixation after ACL reconstruction using CT scan

Ahemad

Anerao

2018

Int J Res Orthop

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“…During this time, the reconstructed knees are restricted from vigorous use because of pain. Weiler et al (1998) performed comparisons using flexor tendons as grafts and observed different behaviors between metallic and bioabsorbable screws. The UFL for the bioabsorbable screw (507 N) was significantly higher than that for the metallic screw (419 N).…”

Section: Discussionmentioning

confidence: 99%

“…The stiffness of the tested graft fixation devices was lower than that of the original ACL (182 N/mm (Noyes et al, 1984), 242 N/ mm (Woo et al, 1992), 303 N/mm (Rowden et al, 1997)). Weiler et al (1998) performed comparisons with the flexor tendon as a graft and found different behaviors for metallic and bioabsorbable screws. The linear stiffness of the bioabsorbable screw (57.9 N/ mm) was significantly higher than that of the metallic screw (39.7 N/mm).…”

Section: Discussionmentioning

confidence: 99%

Graft tendon slippage with metallic and bioabsorbable interference screws under cyclic load: a biomechanical study in a porcine model

et al. 2015

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Introduction: The rupture of the anterior cruciate ligament (ACL) is the most common type of knee injury.Reconstructive surgery is the 'gold standard' treatment. During the immediate post-operative period, the fixation of the graft is entirely dependent on the ability of the grafted implant to be secured inside the bone tunnel under the cyclical loads associated with daily tasks. Poor fixation can lead to graft slippage, thus impairing the healing and integration of the graft. The aim of this study was to evaluate the biomechanical performance of tendon graft fixation devices with metallic and bioabsorbable interference screws. Methods: Twenty ACL reconstructions were carried out in porcine tibias using deep flexor tendons to fix 9 × 20 mm metallic (n=10) and PLLA 70/30 bioabsorbable screws (n=10). To verify the ability of a construct to resist immediate postoperative (PO) rehabilitation protocols for immediate load bearing, a cyclic loading test was applied with 50-250 N of tensile force at 1 Hz for 1000 cycles, and the displacement was measured at 10, 50, 100, 500 and 1000 load cycles to quantify the slippage of the graft during the test. After the cyclic loading test, a singlecycle load-to-failure test was applied. Results: The slippage of the graft using metallic screws did not differ (P = 0.616) from that observed when using bioabsorbable screws. Conclusion: The results obtained in this experiment indicate that metallic screws may promote a similar amount of graft slippage during low cyclic loading as bioabsorbable screws. Additionally, there was no difference in the biomechanical performance of these two types of screws during high failure loads.

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“…[2][3][4][5][6] It is known that the biomechanical resistance of these tendons is as much as double the resistance of the ACL, 3,7,8 yet the weak link of this surgery is fixation of the tendons to the bone tunnel. 2,[9][10][11] Inadequate fixation can lead to failure in biological integration of the graft and consequently, anterior knee laxity with positive Lachman, Anterior Drawer and Pivot Shift tests. 12 There are many materials for the fixation of these tendons on the femur and on the tibia, and the surgical cost and technique vary a great deal.…”

Section: Introductionmentioning

confidence: 99%

“…3 However, titanium interference screws present biomechanical results that can compromise graft fixation when studied in cadavers, or non-human models. 3,8,9,11,14,15,17,18 But it is also known that in cadavers and in non-human models the bone mineral density might not be appropriate for comparison with live human beings, compromising the results. 3,19 In the studies comparing transcondylar fixation methods with the interference screw in live human beings or where these fixation methods were investigated separately, the clinical results were similar and satisfactory.…”

Section: Introductionmentioning

confidence: 99%

Comparação entre parafuso de interferência e transcondilar na reconstrução do LCA

Danieli

Padovani

2011

Acta ortop. bras.

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Objective: Femoral fixation in ACL reconstruction with flexor tendon grafts can vary greatly according to the provision of materials and the surgeon's experience. But studies comparing fixation systems are most often performed on cadavers or animals, without evaluating the clinical results, which affects their comparison with live human patients. This article evaluates the clinical and subjective outcomes of two methods of graft fixation to the femur (Titanium interference screw and titanium transcondylar device) to determine whether there is any difference between these methods. Methods: Forty patients with ACL injury were selected. Of these, 20 had their graft fixed to the femur with interference screw and 20 with the transcondylar device. All the patients were reevaluated at least two years postoperatively by the anterior drawer test, pivot shift test and Lachman test, as well as obtaining the Lysholm and IKDC (International Knee Documentation Committee) scores. Results: The results were not statistically different for the criteria evaluated, which leads to the conclusion that. Conclusion: Both forms of fixation are effective for this technique, within the parameters established. Level of Evidence II, Prospective Comparative study.

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Hamstring tendon fixation using interference screws: a biomechanical study in calf tibial bone

Cited by 195 publications

References 50 publications

Comparison of tunnel widening between interference screw and suture disc fixation after ACL reconstruction using CT scan

Comparison of tunnel widening between interference screw and suture disc fixation after ACL reconstruction using CT scan

Graft tendon slippage with metallic and bioabsorbable interference screws under cyclic load: a biomechanical study in a porcine model

Comparação entre parafuso de interferência e transcondilar na reconstrução do LCA

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