Howell Stephen M, Roos Phil, Hull Maury L
Department of Mechanical Engineering, University of California at Davis, Davis, CA, USA.
Am J Sports Med. 2005 May;33(5):719-25. doi: 10.1177/0363546504269939. Epub 2005 Feb 16.
Despite increasing attention on fixation of a soft tissue anterior cruciate ligament graft in the tibia, there have been no studies on the use of a bone dowel as a joint line fixation device for promoting fixation properties, especially stiffness at the time of implantation.
To determine whether compacting a bone dowel into the tibial tunnel improves fixation stiffness, yield load, and resistance to slippage of a soft tissue anterior cruciate ligament graft.
Controlled laboratory study.
A double-looped tendon graft was fixed at the distal end of the tibial tunnel with a WasherLoc in 24 calf tibias. The tibial tunnels were treated with or without a dowel of cancellous bone. The bone dowel was harvested from the tibial tunnel and then compacted into a tapered space anterior to the anterior cruciate ligament graft as a joint line fixation device. A cyclic load and measurement test was administered to determine fixation stiffness, yield load, slippage, and failure mode.
The specimens with the bone dowel had 58 N/mm more stiffness (P = .04); however, the yield load and resistance to slippage were similar in specimens with and without the bone dowel.
A bone dowel harvested from the tibial tunnel can be used as a joint line fixation device in series with a distal fixation method to improve initial fixation stiffness and increase the fit, which is known to enhance tendon graft-to-bone healing in the tibia.
尽管对软组织前交叉韧带移植物在胫骨中的固定越来越受到关注，但尚无关于使用骨栓作为关节线固定装置以提高固定性能，特别是植入时刚度的研究。
确定将骨栓压实到胫骨隧道中是否能提高软组织前交叉韧带移植物的固定刚度、屈服载荷和抗滑移性。
对照实验室研究。
在24个小牛胫骨的胫骨隧道远端用WasherLoc固定双环肌腱移植物。胫骨隧道分别用或不用松质骨栓处理。从胫骨隧道获取骨栓，然后将其压实到前交叉韧带移植物前方的锥形空间中作为关节线固定装置。进行循环载荷和测量测试以确定固定刚度、屈服载荷、滑移和失效模式。
使用骨栓的标本刚度高58 N/mm（P = .04）；然而，使用和不使用骨栓的标本的屈服载荷和抗滑移性相似。
从胫骨隧道获取的骨栓可与远端固定方法串联用作关节线固定装置，以提高初始固定刚度并增加贴合度，已知这可增强胫骨中肌腱移植物与骨的愈合。
