Ettinger M, Liodakis E, Haasper C, Hurschler C, Breitmeier D, Krettek C, Jagodzinski M
Abteilung für Unfallchirurgie, Medizinische Hochschule Hannover, Carl-Neuberg-Straße 1, 30625, Hannover, Deutschland.
Unfallchirurg. 2012 Sep;115(9):811-5. doi: 10.1007/s00113-010-1944-z.
Press-fit fixation of hamstring tendon autografts for anterior cruciate ligament reconstruction is an interesting technique because no hardware is necessary. This study compares the biomechanical properties of press-fit fixations to an interference screw fixation.
Twenty-eight human cadaveric knees were used for hamstring tendon explantation. An additional bone block was harvested from the tibia. We used 28 porcine femora for graft fixation. Constructs were cyclically stretched and then loaded until failure. Maximum load to failure, stiffness and elongation during failure testing and cyclic loading were investigated.
The maximum load to failure was 970±83 N for the press-fit tape fixation (T), 572±151 N for the bone bridge fixation (TS), 544±109 N for the interference screw fixation (I), 402±77 N for the press-fit suture fixation (S) and 290±74 N for the bone block fixation technique (F). The T fixation had a significantly better maximum load to failure compared to all other techniques (p<0.001).
This study demonstrates that a tibial press-fit technique which uses an additional bone block has better maximum load to failure results compared to a simple interference screw fixation.
自体腘绳肌腱移植前交叉韧带重建的压配固定是一种有趣的技术,因为无需使用硬件。本研究比较了压配固定与干涉螺钉固定的生物力学特性。
使用28个尸体膝关节进行腘绳肌腱取出。从胫骨获取额外的骨块。我们使用28个猪股骨进行移植物固定。构建物进行循环拉伸,然后加载直至失效。研究了失效测试和循环加载期间的最大失效载荷、刚度和伸长率。
压配带固定(T)的最大失效载荷为970±83N,骨桥固定(TS)为572±151N,干涉螺钉固定(I)为544±109N,压配缝线固定(S)为402±77N,骨块固定技术(F)为290±74N。与所有其他技术相比,T固定的最大失效载荷显著更好(p<0.001)。
本研究表明,与简单的干涉螺钉固定相比,使用额外骨块的胫骨压配技术具有更好的最大失效载荷结果。