Fullick Robert, Parks Brent, Hinton Richard
Department of Orthopaedics, Union Memorial Hospital, Baltimore, Maryland 21218, USA.
J Knee Surg. 2011 Dec;24(4):285-8. doi: 10.1055/s-0031-1286191.
We evaluated interference screw fixation in a plug-tunnel construct using bioabsorbable screws as void fillers with different percentages of the screw removed. Nine-millimeter tunnels in a closed-cell foam block were filled with a 10-mm bioabsorbable screw, and 10-mm revision tunnels were placed in parallel with tunnel overlap resulting in removal of 10%, 25%, or 50% of the screw diameter. Synthetic bone plugs were fashioned to fit 10-mm tunnels. In all groups, the plugs were secured in standard interference fixation with a 9-mm metal screw between the void-filling bioabsorbable screw and plug. Failure loads for the control group (no revision tunnel) averaged 926 +/- 44 N, 10% (1024 +/- 129 N) and 25% (932 +/- 129 N) groups were not significantly different; failure load in the 50% diameter group (780 +/- 72 N) was significantly lower than all other groups (p < 0.001). Using a bioabsorbable screw as void filler provided mean load to failure not different from that of standard reconstruction when 10 and 25% of the diameter of the void-filling screw was removed. Load to failure was significantly lower when 50% of the void-filling screw diameter group was removed. This may be applicable in anterior cruciate ligament reconstruction where a previous tunnel void has to be addressed.
我们评估了在栓道结构中使用生物可吸收螺钉作为空隙填充物且去除不同百分比螺钉的干涉螺钉固定情况。在闭孔泡沫块中制作9毫米的隧道，用10毫米的生物可吸收螺钉填充，并行放置10毫米的修正隧道，使隧道重叠，从而去除10%、25%或50%的螺钉直径。制作合成骨栓以适配10毫米的隧道。在所有组中，骨栓通过在空隙填充生物可吸收螺钉和骨栓之间使用9毫米金属螺钉进行标准干涉固定。对照组（无修正隧道）的失效载荷平均为926±44牛，10%（1024±129牛）和25%（932±129牛）组无显著差异；50%直径组的失效载荷（780±72牛）显著低于所有其他组（p<0.001）。当去除空隙填充螺钉直径的10%和25%时，使用生物可吸收螺钉作为空隙填充物提供的平均失效载荷与标准重建的无差异。当去除50%的空隙填充螺钉直径组时，失效载荷显著降低。这可能适用于前交叉韧带重建中必须处理先前隧道空隙的情况。
