Cem Yıldırım, Mehmet Demirel, Emre Koraman, Osman Görkem Muratoğlu, Fatih Yamak, Süreyya Ergün Bozdağ, Yavuz Kocabey
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Each graft fixation was exposed to cyclic loading conditions. Significant differences were determined in failure load among the three groups (<i>p</i> = 0.008). The mean failure load was significantly higher in group B (717.04 ± 218.51 N) than in group A (308.03 ± 17.22 N) (<i>p</i> = 0.006). No significant differences were observed among the groups regarding axial stiffness (<i>p</i> = 0.442). Cyclic displacement differed significantly among the three groups (<i>p</i> = 0.005). In pairwise comparisons, the mean cyclic displacement was significantly higher in group A (8.22 ± 3.24 mm) compared with group C (1.49 ± 0.41 mm) (<i>p</i> = 0.005). Failure displacement varied considerably among the groups (<i>p</i> = 0.037). Although group B (15.53 ± 6.43 mm) exhibited a greater mean failure displacement than both group A (4.9 ± 0.75 mm) and group C (8.84 ± 4.65 mm), these differences did not reach statistical significance (<i>p</i> = 0.602 and <i>p</i> = 0.329, respectively). Interference screw fixation alone and supplementary staple fixation have biomechanically similar characteristics in terms of initial strength and stiffness of tibial ACL soft tissue graft fixation. Regardless of staple use, an interference screw with the same diameter as the tibial tunnel can ensure sufficient tensile strength in tibial ACL graft fixation.</p> ","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":null,"pages":null},"PeriodicalIF":1.6000,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The Effect of Supplementary Staple Fixation on Biomechanical Properties of Soft Tissue Graft Tibial Fixation in Anterior Cruciate Ligament Reconstruction\",\"authors\":\"Cem Yıldırım, Mehmet Demirel, Emre Koraman, Osman Görkem Muratoğlu, Fatih Yamak, Süreyya Ergün Bozdağ, Yavuz Kocabey\",\"doi\":\"10.1055/s-0044-1786007\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p>This study aimed to test and compare the biomechanical properties of three tibial fixation methods of anterior cruciate ligament (ACL) tendon grafts under cyclic load and load-to-failure testing in the bovine proximal tibiae, comprising (1) staple fixation alone, (2) interference screw fixation alone, and (3) interference screw fixation with a supplementary staple. Twenty-four bovine tibiae used in the study were divided into three groups (eight proximal tibiae in each group) based on tibial fixation methods of ACL tendon grafts: group A (a spiked ligament staple alone), group B (a cannulated interference screw alone), and group C (a cannulated interference screw with a supplementary staple). Each graft fixation was exposed to cyclic loading conditions. Significant differences were determined in failure load among the three groups (<i>p</i> = 0.008). The mean failure load was significantly higher in group B (717.04 ± 218.51 N) than in group A (308.03 ± 17.22 N) (<i>p</i> = 0.006). No significant differences were observed among the groups regarding axial stiffness (<i>p</i> = 0.442). Cyclic displacement differed significantly among the three groups (<i>p</i> = 0.005). In pairwise comparisons, the mean cyclic displacement was significantly higher in group A (8.22 ± 3.24 mm) compared with group C (1.49 ± 0.41 mm) (<i>p</i> = 0.005). Failure displacement varied considerably among the groups (<i>p</i> = 0.037). Although group B (15.53 ± 6.43 mm) exhibited a greater mean failure displacement than both group A (4.9 ± 0.75 mm) and group C (8.84 ± 4.65 mm), these differences did not reach statistical significance (<i>p</i> = 0.602 and <i>p</i> = 0.329, respectively). Interference screw fixation alone and supplementary staple fixation have biomechanically similar characteristics in terms of initial strength and stiffness of tibial ACL soft tissue graft fixation. 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引用次数: 0
摘要
本研究旨在测试和比较前交叉韧带(ACL)肌腱移植物的三种胫骨固定方法在牛胫骨近端循环载荷和载荷-失效测试下的生物力学特性,包括(1)单纯钉书针固定、(2)单纯过盈螺钉固定和(3)过盈螺钉固定加辅助钉书针。根据前交叉韧带肌腱移植物的胫骨固定方法,研究中使用的 24 块牛胫骨被分为三组(每组 8 块近端胫骨):A 组(仅使用带钉韧带钉)、B 组(仅使用带套管的干扰螺钉)和 C 组(使用带套管的干扰螺钉和辅助钉)。每种移植物固定方式都受到循环加载条件的影响。三组的破坏载荷存在显著差异(P = 0.008)。B 组的平均破坏载荷(717.04 ± 218.51 N)明显高于 A 组(308.03 ± 17.22 N)(p = 0.006)。各组在轴向刚度方面无明显差异(p = 0.442)。三组之间的周期位移差异较大(p = 0.005)。在成对比较中,A 组的平均循环位移(8.22 ± 3.24 毫米)明显高于 C 组(1.49 ± 0.41 毫米)(p = 0.005)。各组之间的破坏位移差异很大(p = 0.037)。虽然 B 组(15.53 ± 6.43 毫米)的平均破坏位移大于 A 组(4.9 ± 0.75 毫米)和 C 组(8.84 ± 4.65 毫米),但这些差异未达到统计学意义(分别为 p = 0.602 和 p = 0.329)。就胫骨前交叉韧带软组织移植物固定的初始强度和刚度而言,单独使用干扰螺钉固定和辅助使用钉书针固定具有相似的生物力学特征。无论使用何种钉书针,与胫骨隧道直径相同的干扰螺钉都能确保胫骨前交叉韧带移植物固定具有足够的拉伸强度。
The Effect of Supplementary Staple Fixation on Biomechanical Properties of Soft Tissue Graft Tibial Fixation in Anterior Cruciate Ligament Reconstruction
This study aimed to test and compare the biomechanical properties of three tibial fixation methods of anterior cruciate ligament (ACL) tendon grafts under cyclic load and load-to-failure testing in the bovine proximal tibiae, comprising (1) staple fixation alone, (2) interference screw fixation alone, and (3) interference screw fixation with a supplementary staple. Twenty-four bovine tibiae used in the study were divided into three groups (eight proximal tibiae in each group) based on tibial fixation methods of ACL tendon grafts: group A (a spiked ligament staple alone), group B (a cannulated interference screw alone), and group C (a cannulated interference screw with a supplementary staple). Each graft fixation was exposed to cyclic loading conditions. Significant differences were determined in failure load among the three groups (p = 0.008). The mean failure load was significantly higher in group B (717.04 ± 218.51 N) than in group A (308.03 ± 17.22 N) (p = 0.006). No significant differences were observed among the groups regarding axial stiffness (p = 0.442). Cyclic displacement differed significantly among the three groups (p = 0.005). In pairwise comparisons, the mean cyclic displacement was significantly higher in group A (8.22 ± 3.24 mm) compared with group C (1.49 ± 0.41 mm) (p = 0.005). Failure displacement varied considerably among the groups (p = 0.037). Although group B (15.53 ± 6.43 mm) exhibited a greater mean failure displacement than both group A (4.9 ± 0.75 mm) and group C (8.84 ± 4.65 mm), these differences did not reach statistical significance (p = 0.602 and p = 0.329, respectively). Interference screw fixation alone and supplementary staple fixation have biomechanically similar characteristics in terms of initial strength and stiffness of tibial ACL soft tissue graft fixation. Regardless of staple use, an interference screw with the same diameter as the tibial tunnel can ensure sufficient tensile strength in tibial ACL graft fixation.
期刊介绍:
The Journal of Knee Surgery covers a range of issues relating to the orthopaedic techniques of arthroscopy, arthroplasty, and reconstructive surgery of the knee joint. In addition to original peer-review articles, this periodical provides details on emerging surgical techniques, as well as reviews and special focus sections. Topics of interest include cruciate ligament repair and reconstruction, bone grafting, cartilage regeneration, and magnetic resonance imaging.