Reverse Anterior Cruciate Ligament Reconstruction Fixation: A Biomechanical Comparison Study of Tibial Cross-Pin and Femoral Interference Screw Fixation

Lawley, Richard; Klein, Samuel E.; Chudik, Steven C.

doi:10.1016/j.arthro.2016.09.006

Cited by 10 publications

(8 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This step simulates the ACL load bearing in a passive extension during the gait as well as modeling early rehabilitation protocols of flexion-extension loading in a reconstructed graft. [27][28][29] At the end of the cyclical loading, if the sample survived, a pullout load with a loading rate of 20 mm/min was applied to the specimens to measure the ultimate strength of the fixation. 30 The mode of failure was observed and recorded for each test.…”

Section: Mechanical Testingmentioning

confidence: 99%

Effect of Geometry on the Fixation Strength of Anterior Cruciate Ligament Reconstruction Using BASHTI Technique

et al. 2020

View full text Add to dashboard Cite

The goal of this study is to investigate the effects of tendon and cannulated drill bit diameter on the strength of the bone and site hold tendon inside (BASHTI) fixation technique for an anterior cruciate ligament (ACL) reconstruction. Bovine digital tendons and Sawbones blocks were used to mimic the ACL reconstruction. Mechanical strength of the specimens was measured using a cyclic loading continued by a single cycle pullout load until failure to simulate the real postsurgical loading conditions. Finally, failure modes of specimens and ultimate failure load were recorded. The maximum possible tendon surface strain (i.e., tendon compression [TC]) for tendon diameters of 6, 7, 8, and 9 mm were 0.73, 0.8, 0.7, and 0.65, respectively. Eighty per cent of the specimens with tendon diameter of 6 mm and 20% of specimens with tendon diameter of 7 mm failed on the torn tendon. All samples with larger tendon diameters (i.e., 8 and 9 mm) failed on the fixation slippage. The maximum fixation strength according to the most suitable core bones for 6, 7, 8, and 9 mm tendons were 148 ± 47 N (core 9.5 mm), 258 ± 66 N (core 9.5 mm), 386 ± 128 N (core 8.5 mm), and 348 ± 146 N (core 8.5 mm), respectively. The mode of tendon failure was significantly influenced by the tendon diameter. Also, an increase in TC raised the fixation strength for all tendon diameters; however, tendon over compression decreased the fixation strength for the 8 mm tendon group. Finally, an empirical equation was proposed to predict BASHTI fixation strength.

show abstract

Section: Mechanical Testingmentioning

confidence: 99%

Effect of Geometry on the Fixation Strength of Anterior Cruciate Ligament Reconstruction Using BASHTI Technique

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Previous studies have reported similar biomechanical properties during soft tissue fixation with different screws 12 . In addition, in the biomechanical study of tibial soft tissue graft fixation, metal interference screws are often used for soft tissue graft fixation 27 . Fourth, we did not assess the elongation pattern of the graft in this study.…”

Section: Limitationsmentioning

confidence: 92%

Biomechanical Comparison of Anatomic Versus Lower of Anteromedial and Anterolateral Tibial Tunnels in Posterior Cruciate Ligament Reconstruction

Peng

Tang

Jia

et al. 2023

Orthopaedic Surgery

View full text Add to dashboard Cite

Objective In order to reduce the “killer turn” effect, various tibial tunnels have been developed. However, few studies investigated the biomechanical effects of different tibial tunnels during PCL reconstruction. This study aims to compare the time‐zero biomechanical properties of anteromedial, anterolateral, lower anteromedial, and lower anterolateral tibial tunnels in transtibial posterior cruciate ligament (PCL) reconstruction under load‐to‐failure loading. Methods Porcine tibias and bovine extensor tendons were used to simulate in vitro transtibial PCL reconstruction. Forty bovine extensor tendons and 40 porcine tibias were randomly divided into four experimental groups: anteromedial tunnel group (AM group, n = 10), anterolateral tunnel group (AL group, n = 10), lower anteromedial tunnel group (L‐AM group, n = 10), and lower anterolateral tunnel group (L‐AL group, n = 10). The biomechanical test was then carried out in each group using the load‐to‐failure test. The ultimate load (in newtons), yield load (in newtons), tensile stiffness (in newtons per millimeter), load‐elongation curve, failure mode, and tibial tunnel length (in millimeter) were recorded for each specimen. One‐way analysis of variance (ANOVA) was used to compare the mean differences among the four groups. Results The biomechanical outcomes showed that there were no differences in the mean tensile stiffness and failure mode among four groups. The ultimate load and yield load of the L‐AM group were significantly higher than those of other three groups (P < 0.05). For the AM group, its ultimate load is significantly higher than that of the L‐AL group (P < 0.05), and its yield load is higher than that of the AL group and L‐AL group (P < 0.05). However, we found no significant differences in either ultimate load or yield load between AL group and L‐AL group (P > 0.05). There was significant statistical difference in the length of tibial tunnel between anatomic groups (AM and AL) and lower groups (L‐AM and L‐AL) (P < 0.05). Conclusion Compared with the anteromedial, anterolateral, and lower anterolateral tibial tunnel, the lower anteromedial tibial tunnel showed better time‐zero biomechanical properties including ultimate load and yield load in transtibial PCL reconstruction.

show abstract

“…Second, a titanium interference screw was selected to x the graft instead of bio-interference screws or PEEK (polyether ether ketone) screws, which are commonly used in clinical practice. One reason was that the titanium interference screw was commonly used in biomechanical studies of soft-tissue graft tibial xation 22,23 . Moreover, Aga et al 9 have observed no signi cant differences in soft-tissue xation properties among the 3 screw materials.…”

Section: Limitationsmentioning

confidence: 99%

Surgically adjust tibial tunnel in anatomical anterior cruciate ligament single-bundle reconstruction: A time-zero biomechanical study in vitro

Wang

Teng

Peng

et al. 2023

J Orthop Surg (Hong Kong)

View full text Add to dashboard Cite

Background The anatomical positioning of the graft during anterior cruciate ligament reconstruction (ACLR) is of great significance for restoring normal knee kinematics and preventing early joint degeneration. Therefore, the adjustment of the mispositioned guide pin becomes extremely important. Our research aims to test the time-zero biomechanical properties in adjusting inaccurate guide pins to the center of the tibial footprint in anatomical anterior cruciate ligament single-bundle reconstruction. Methods Porcine tibias and bovine extensor tendons were used to simulate a transtibial ACL reconstruction in vitro. Load-to failure testing was carried out in 4 groups: control group ( n = 45): the guide pin was drilled at the center of the ACL footprint; group I, group II and group III ( n = 45, respectively): the guide pin was respectively drilled 1 mm, 2 mm and 3 mm away from the center of the ACL footprint. In the experimental groups, a small tunnel with a 4.5 mm reamer is made and the guide pin is shifted to the center of the footprint. All the reamed tibias were scanned by CT to measure the area of the tunnel in the footprint, and time-zero biomechanical properties were recorded. Results All graft-tibia complexes failed because the grafts slipped past the interference screws. Compare to control group, the ultimate load, yield load, and tunnel exit area in group III decreased significantly ( p < 0.05). Regarding to the ultimate load, yield load, tensile stiffness, twisting force and tunnel exit area, t-test showed no significant differences between control group and group I, group II respectively ( p > 0.05). Pearson test showed that tunnel exit area was negatively correlated with other characteristics ( p < 0.05). Conclusions Surgical adjustment of the guide pin to the center of the tibial footprint may have significant influence in time-zero biomechanical properties in anatomical anterior cruciate ligament single-bundle reconstruction when the adjusted tibial tunnel was significantly enlarged compare to the standard tibial tunnel.

show abstract

Reverse Anterior Cruciate Ligament Reconstruction Fixation: A Biomechanical Comparison Study of Tibial Cross-Pin and Femoral Interference Screw Fixation

Cited by 10 publications

References 24 publications

Effect of Geometry on the Fixation Strength of Anterior Cruciate Ligament Reconstruction Using BASHTI Technique

Effect of Geometry on the Fixation Strength of Anterior Cruciate Ligament Reconstruction Using BASHTI Technique

Biomechanical Comparison of Anatomic Versus Lower of Anteromedial and Anterolateral Tibial Tunnels in Posterior Cruciate Ligament Reconstruction

Surgically adjust tibial tunnel in anatomical anterior cruciate ligament single-bundle reconstruction: A time-zero biomechanical study in vitro

Contact Info

Product

Resources

About