Scannell Brian P, Loeffler Bryan J, Hoenig Michael, Peindl Richard D, D'Alessandro Donald F, Connor Patrick M, Fleischli James E
Department of Orthopaedic Surgery, Carolinas Medical Center, Charlotte, NC.
Am J Orthop (Belle Mead NJ). 2015 Jan;44(1):32-6.
We conducted a study to biomechanically compare 5 femoral hamstring tendon fixation devices commonly used in anterior cruciate ligament reconstruction. Quadrupled human semitendinosus-gracilis tendon grafts were fixed into porcine femurs using 5 separate fixation devices. For each device, 10 specimens were tested (1500-cycle loading test at 50-200 N). Specimens surviving the cyclic loading then underwent a single load-to-failure (LTF) test. Failure mode, stiffness, ultimate load, and rigidity were recorded. Two of 10 Delta screw (Arthrex), 10 of 10 Bio-TransFix (Arthrex), 10 of 10 Bone Mulch screw (Arthrotek), 10 of 10 EZLoc (Arthrotek), and 10 of 10 Zip Loop (Arthrotek) devices completed the 1500-cycle loading test. Residual displacement was lowest for Bio-TransFix (4.1 mm) followed by Bone Mulch (5.2 mm), EZLoc (6.4 mm), Zip Loop (6.8 mm), and Delta (8.2 mm). Mean stiffness was significantly (P < .001) higher for Bone Mulch (218 N/mm) than for Bio-TransFix (171 N/mm), EZLoc (122 N/mm), Zip Loop (105 N/mm), or Delta (84 N/mm). Mean LTF was significantly ( P < .001) higher for Bone Mulch (867 N) than for Zip Loop (615 N), Bio-TransFix (552 N), EZLoc (476 N), or Delta (410 N). The Bone Mulch screw demonstrated superior strength in the fixation of hamstring grafts in the femur. Bio-TransFix was close behind. The Delta screw demonstrated poor displacement, stiffness, and LTF. When used as the sole femoral fixation device, a device with low LTF, decreased stiffness, and high residual displacement should be used cautiously in patients undergoing aggressive rehabilitation.
我们开展了一项研究，对常用于前交叉韧带重建的5种股薄肌腱固定装置进行生物力学比较。使用4股人半腱肌-股薄肌腱移植物，通过5种不同的固定装置将其固定于猪股骨中。对于每种装置，测试10个标本（在50 - 200 N下进行1500次循环加载测试）。经受循环加载后存活的标本随后进行单次破坏载荷（LTF）测试。记录破坏模式、刚度、极限载荷和刚性。10个Delta螺钉（Arthrex公司）中有2个、10个Bio - TransFix（Arthrex公司）、10个碎骨螺钉（Arthrotek公司）、10个EZLoc（Arthrotek公司）以及10个Zip Loop（Arthrotek公司）装置完成了1500次循环加载测试。Bio - TransFix的残余位移最低（4.1 mm），其次是碎骨螺钉（5.2 mm）、EZLoc（6.4 mm）、Zip Loop（6.8 mm）和Delta（8.2 mm）。碎骨螺钉的平均刚度（218 N/mm）显著高于Bio - TransFix（171 N/mm）、EZLoc（122 N/mm）、Zip Loop（105 N/mm）或Delta（84 N/mm）（P <.001）。碎骨螺钉的平均破坏载荷（867 N）显著高于Zip Loop（615 N）、Bio - TransFix（552 N）、EZLoc（476 N）或Delta（410 N）（P <.001）。碎骨螺钉在股骨中固定腘绳肌移植物时表现出卓越的强度。Bio - TransFix紧随其后。Delta螺钉在位移、刚度和破坏载荷方面表现不佳。当作为唯一的股骨固定装置使用时，对于接受积极康复治疗的患者，破坏载荷低、刚度降低且残余位移高的装置应谨慎使用。
