Nakano H, Yasuda K, Tohyama H, Yamanaka M, Wada T, Kaneda K
Department of Orthopaedic Surgery, School of Medicine, Hokkaido University, Kitu-ku-Kita-15 Nishi 7, Sapporo, Japan.
Clin Biomech (Bristol). 2000 Mar;15(3):188-95. doi: 10.1016/s0268-0033(99)00065-0.
To biomechanically evaluate interference screw fixation of the doubled flexor tendon graft in anterior cruciate ligament reconstruction using cyclic elongation.
Biomechanical properties of the interference screw fixation of the flexor tendons were compared with those of three standard fixation techniques which had been commonly performed in anterior cruciate ligament reconstruction.
The interference screw fixation of the flexor tendon graft has attracted notice because of various possible advantages.
Forty fresh frozen porcine hind limbs were divided into four groups of ten knees each. Anterior cruciate ligament reconstruction was carried out in each group using one of four different procedures. For each group, five femur-graft-tibia complexes underwent submaximal cyclic elongation of 5000 cycles after initial tension of 80 N was applied. Then, tensile testing was performed in the same manner for the complex with a tensile tester. The remaining five complexes were examined in the same tensile test without applying any cyclic elongation.
The initial tension was more rapidly relaxed by cyclic elongation in the flexor tendon graft fixed with interference screws than in the bone-patellar tendon-bone graft fixed with two standard techniques. After cyclic elongation, while the ultimate failure load of the former was significantly lower than the latter, the linear stiffness of the former was significantly higher than the flexor tendon graft fixed with sutures.
The present study has clarified that the advantage of the interference fixation for the doubled flexor tendon graft is the high linear stiffness of the FGT complex, and the disadvantage of this screw is the low ultimate failure load of the FGT complex.
The present study has suggested that vigorous activities should not be permitted for the patients in the early period after anterior cruciate ligament reconstruction using this fixation technique, because of its low ultimate failure load.
采用循环拉伸对前交叉韧带重建中双股屈肌腱移植的干涉螺钉固定进行生物力学评估。
将屈肌腱干涉螺钉固定的生物力学特性与前交叉韧带重建中常用的三种标准固定技术的生物力学特性进行比较。
屈肌腱移植的干涉螺钉固定因其多种潜在优势而受到关注。
40只新鲜冷冻猪后肢，每组10个膝关节，分为四组。每组采用四种不同手术方法之一进行前交叉韧带重建。每组中，五个股骨 - 移植物 - 胫骨复合体在施加80N初始张力后进行5000次亚最大循环拉伸。然后，使用拉伸试验机以相同方式对复合体进行拉伸测试。其余五个复合体在不进行任何循环拉伸的情况下进行相同的拉伸测试。
与采用两种标准技术固定的骨 - 髌腱 - 骨移植物相比，用干涉螺钉固定的屈肌腱移植物在循环拉伸下初始张力松弛更快。循环拉伸后，前者的极限破坏载荷虽显著低于后者，但其线性刚度显著高于用缝线固定的屈肌腱移植物。
本研究阐明，双股屈肌腱移植干涉固定的优点是FGT复合体的线性刚度高，缺点是FGT复合体的极限破坏载荷低。
本研究表明，由于极限破坏载荷低，采用这种固定技术进行前交叉韧带重建的患者在术后早期不应进行剧烈活动。
