Effects of Tunnel Dilation and Interference Screw Position on the Biomechanical Properties of Tendon Graft Fixation for Anterior Cruciate Ligament Reconstruction

2013 ◽  
Vol 29 (11) ◽  
pp. 1804-1810 ◽  
Author(s):  
Masanori Higano ◽  
Yomei Tachibana ◽  
Katunobu Sakaguchi ◽  
Tatsuru Goto ◽  
Hiromi Oda
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Biomechanical Properties ◽  
Tendon Graft ◽  
Interference Screw ◽  
Cruciate Ligament Reconstruction ◽  
Screw Position ◽  
Anterior Cruciate

Evolgate Fixation of Doubled Flexor Graft in Anterior Cruciate Ligament Reconstruction: Biomechanical Evaluation with Cyclic Loading

2005 ◽  
Vol 33 (4) ◽  
pp. 574-582 ◽  
Author(s):  
Andrea Ferretti ◽  
Fabio Conteduca ◽  
Luca Labianca ◽  
Edoardo Monaco ◽  
Angelo De Carli
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cyclic Loading ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Biomechanical Properties ◽  
Interference Screw ◽  
Graft Fixation ◽  
Cruciate Ligament Reconstruction ◽  
Anterior Cruciate

Background The weakest points in hamstrings anterior cruciate ligament reconstruction are its points of fixation, especially on the tibial side. Methods for graft fixation to bone should be strong enough to avoid failure, stiff enough to restore load-displacement response, and secure enough to resist slippage under cyclic loading. Hypothesis Biomechanical properties of the interference screw can be improved by reinforcing the walls of the tunnel with a metal spiral (Evolgate fixation). Study Design Controlled laboratory study. Methods Three paired tests were performed using common digital extensor bovine tendons fixed to porcine tibias with interference screw, Intrafix, and Evolgate; critical graft fixation conditions were simulated by applying subsequent cycles to the graft before loading the graft until failure. Results The strength, stiffness, and resistance to slippage of the Evolgate were significantly higher than those of the interference screw; the ultimate failure load of the Evolgate was significantly higher than that of the Intrafix (1058 ± 130 N and 832 ± 156 N, respectively; P =. 02). No statistically significant differences were found between Evolgate and Intrafix regarding the stiffness and slippage under cyclic load. Conclusion Evolgate fixation seems to be stronger, stiffer, and more resistant to slippage than is interference screw fixation of similar length, and it is stronger but not stiffer than Intrafix. Clinical Relevance The Evolgate provides structural properties that seem to be appropriate for an intensive rehabilitation after anterior cruciate ligament reconstruction using a doubled semitendinosus and gracilis graft.

Multistranded Hamstring Tendon Graft Fixation with a Central Four-Quadrant or a Standard Tibial Interference Screw for Anterior Cruciate Ligament Reconstruction

2003 ◽  
Vol 31 (3) ◽  
pp. 338-344 ◽  
Author(s):  
David W. Starch ◽  
Jerry W. Alexander ◽  
Philip C. Noble ◽  
Suraj Reddy ◽  
David M. Lintner
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Hamstring Tendon ◽  
Tendon Graft ◽  
Interference Screw ◽  
Cruciate Ligament Reconstruction ◽  
Anterior Cruciate ◽  
Four Quadrant

Background Tibial fixation of hamstring tendon grafts has been the weak link in anterior cruciate ligament reconstruction. Hypothesis Use of a central four-quadrant sleeve and screw provides superior fixation when compared with standard interference screw fixation. Study Design Controlled laboratory study. Methods In eight pairs of cadaveric knees each anterior cruciate ligament was reconstructed using either an interference screw or a central sleeve and screw on the tibial side. The specimens were then subjected to cyclic loading followed by a load-to-failure test. Results The load required to cause 1 and 2 mm of graft laxity, defined as the separation of the femur and the tibia at the points of graft fixation, was significantly greater with the sleeve and screw than with the interference screw (at 2 mm: sleeve and screw, 216.1 ± 30.1 N; interference screw, 167.0 ± 33.2 N). The force at initial slippage for each of the graft strands was significantly higher with use of the central sleeve and screw. Conclusions The four-quadrant sleeve and screw device may provide greater surface area for healing of hamstring tendon grafts and allow equal tensioning of graft strands before fixation. These factors are associated with increased strength of fixation and reduced laxity of the graft after cyclic loading. Clinical Relevance Use of the central four-quadrant sleeve and screw system offers increased strength of fixation in anterior cruciate ligament reconstruction with hamstring tendon graft.

scholarly journals Extra-articular migration of PEEK interference screw after anterior cruciate ligament reconstruction: a report of two cases

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Chao-Hua Fang ◽  
Ming Li ◽  
Yun-Feng Zhang ◽  
Hua Liu
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Tibial Tunnel ◽  
Interference Screw ◽  
Negative Effects ◽  
Cruciate Ligament Reconstruction ◽  
Screw Extrusion ◽  
Anterior Cruciate

Abstract Background The interference screw is the most popular device that fixes the graft for anterior cruciate ligament reconstruction, reducing the incidence of windshield effect and bungee effect. For the screw, either metallic, “bioresorbable,” or polyetheretherketone (PEEK) material is available. PEEK is popular and extensively used due to its stability, biocompatibility, radiolucency, and elastic modulus. Rare relevant complications were reported, but here, we report two cases of extra-articular migrations of PEEK interference screw from the tibial tunnel after anterior cruciate reconstruction. Case report An 18-year-old boy and a 56-year-old woman underwent anterior cruciate ligament reconstruction using a PEEK interference screw to fix the graft in the tibial tunnel. They suffered from screw extrusion from the tibial tunnel after 40 days and six months, respectively, with an incision rupture or palpable subcutaneous mass. They underwent a second operation and recovered well. Conclusions The exact incidence of extra-articular migrations of PEEK interference screws is unknown, but it seems to be quite low; despite this and its uncertain cause, the negative effects caused by the PEEK material need to be considered.

An interference screw made by silk fibroin-based bulk material with high content of hydroxyapatite for anterior cruciate ligament reconstruction in a rabbit model

2021 ◽  
Author(s):  
Zhuo Yan ◽  
Wenbo Chen ◽  
Wenhe Jin ◽  
Yaying Sun ◽  
Kai Gu ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Silk Fibroin ◽  
Ligament Reconstruction ◽  
Bulk Material ◽  
Cruciate Ligament ◽  
Rabbit Model ◽  
Interference Screw ◽  
Cruciate Ligament Reconstruction ◽  
Anterior Cruciate

Upgradation is still in need for the clinical-applied interference screws in anterior cruciate ligament reconstruction for more reliable fixation. Silk fibroin bulk materials offer a promising opportunity for this application...

scholarly journals Autologous conditioned plasma in anterior cruciate ligament reconstruction with hamstrings – short term clinical results

2012 ◽  
Vol 18 (3) ◽  
pp. 111-115
Author(s):  
O.M. Russu ◽  
I. Gergely ◽  
Ancuța Zazgyva ◽  
I. Moldovan ◽  
T.S. Pop
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Clinical Results ◽  
Interference Screw ◽  
Lysholm Score ◽  
Cruciate Ligament Reconstruction ◽  
The Mean ◽  
Anterior Cruciate

Abstract Evaluating the early clinical results of anterior cruciate ligament reconstruction using hamstrings autograft, with interference screw on the tibial side (biocomposite interference screw, ConMed-Linvatec) and continuous closed loop fixation on the femoral side (XO-Button, ConMed-Linvatec), with and without intra-articular injection of autologous conditioned plasma (ACP). Our study included 21 patients with chronic anterior cruciate ligament (ACL) ruptures for whom we performed ACL reconstruction with a hamstrings autograft. The mean age was 34 years (range, 25 to 42), 16 patients were men and 5 were women. In 10 cases we performed an intraarticular infiltration of ACP at the end of the surgical intervention. Final evaluation was performed at the end of the 6th postoperative month using the Lysholm scoring system, Tegner activity scale and objective assessment with the RolimeterTM 50A. The Lysholm score was excellent in all cases at 6 months postoperatively, with a mean Lysholm score of 90 for patients without ACP and 91.09 for patients that received ACP; the mean Tegner activity score was also similar pre- and postoperatively for the two groups (from 3.5 and 3.63 for the group without ACP and the group with ACP to 5.6 and 5.72 respectively). Joint laxity measurement was similar for both groups. We found no graft ruptures. We found similar results after ACL reconstruction with and without intra-articular injection of PRP, but further studies are necessary to determine the exact role of these substances in speeding up the recovery process in these cases.

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