Kousa Petteri, Järvinen Teppo L N, Vihavainen Mika, Kannus Pekka, Järvinen Markku
Department of Surgery, University of Tampere and Tampere University Hospital, Tampere, Finland.
Am J Sports Med. 2003 Mar-Apr;31(2):174-81. doi: 10.1177/03635465030310020401.
Strength of graft fixation is the weakest link in anterior cruciate ligament reconstruction.
There is no difference in initial fixation strength between different hamstring tendon graft femoral fixation devices.
Randomized experimental study.
Each of six devices was used in the fixation of 10 quadrupled human semitendinosus-gracilis tendon grafts in tunnels drilled in porcine femora and tested 10 times with a single-cycle load-to-failure test at a rate of 50 mm/min and 10 times with a 1500-cycle loading test between 50 and 200 N at one cycle every 2 seconds. The specimens that survived the cyclic loading were subjected to a single-cycle load-to-failure test.
The Bone Mulch Screw (1112 N) was strongest in the single-cycle load-to-failure test, followed by EndoButton CL (1086 N), RigidFix (868 N), SmartScrew ACL (794 N), BioScrew (589 N), and RCI screw (546 N). It also showed the lowest residual displacement (2.2 mm) and was strongest in the single-cycle load-to-failure test after cyclic loading.
The Bone Mulch Screw was superior to all other devices.
Caution may be warranted in employing aggressive rehabilitation after reconstruction with these devices. Preconditioning of the graft-implant complex before fixation is important.
移植物固定强度是前交叉韧带重建中最薄弱的环节。
不同的腘绳肌腱移植物股骨固定装置在初始固定强度上没有差异。
随机实验研究。
六种装置中的每一种都用于在猪股骨上钻出的隧道中固定10条四倍体人半腱肌-股薄肌腱移植物，并以50毫米/分钟的速率进行单周期破坏载荷试验10次，以及在50至200牛之间以每2秒一个周期进行1500次循环加载试验10次。在循环加载中存活的标本进行单周期破坏载荷试验。
骨屑螺钉（1112牛）在单周期破坏载荷试验中最强，其次是EndoButton CL（1086牛）、RigidFix（868牛）、SmartScrew ACL（794牛）、BioScrew（589牛）和RCI螺钉（546牛）。它还显示出最低的残余位移（2.2毫米），并且在循环加载后的单周期破坏载荷试验中最强。
骨屑螺钉优于所有其他装置。
使用这些装置重建后进行积极康复时可能需要谨慎。固定前对移植物-植入物复合体进行预处理很重要。
