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 Feb;44(2):82-5.
We conducted a study to biomechanically compare 4 tibial hamstring tendon fixation devices commonly used in anterior cruciate ligament reconstruction. Quadrupled human semitendinosus-gracilis tendon grafts were fixed into porcine tibias using 4 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 test. Failure mode, stiffness, ultimate load, and residual displacement were recorded. Eight of 10 Delta screw (Arthrex), 2 of 10 Retroscrew (Arthrex), 10 of 10 WasherLoc (Arthrotek), and 10 of 10 Intrafix (Depuy Mitek) devices completed the 1500-cycle loading test. Residual displacement was significantly (P < .001) lower for Intrafix (2.9 mm), WasherLoc (5.6 mm), and Delta (6.4 mm) than for Retroscrew (25.5 mm). Mean stiffness was significantly (P < .05) higher for Intrafix (129 N/mm) than for the other devices. Mean load to failure was highest for Intrafix (656 N), then WasherLoc (630 N), Delta (430 N), and Retroscrew (285 N). The Intrafix device demonstrated superior strength in the fixation of hamstring grafts in the tibia. WasherLoc was close behind.
我们进行了一项研究，旨在对前交叉韧带重建中常用的4种腘绳肌腱固定装置进行生物力学比较。使用4种不同的固定装置将四倍体人半腱肌-股薄肌腱移植物固定到猪胫骨中。对于每种装置，测试10个标本（在50-200N下进行1500次循环加载测试）。在循环加载中存活的标本随后进行单次破坏载荷测试。记录破坏模式、刚度、极限载荷和残余位移。10个Delta螺钉（Arthrex）装置中有8个、10个Retroscrew（Arthrex）装置中有2个、10个WasherLoc（Arthrotek）装置和10个Intrafix（Depuy Mitek）装置完成了1500次循环加载测试。Intrafix（2.9mm）、WasherLoc（5.6mm）和Delta（6.4mm）的残余位移显著低于Retroscrew（25.5mm）（P <.001）。Intrafix（129N/mm）的平均刚度显著高于其他装置（P <.05）。Intrafix的平均破坏载荷最高（656N），其次是WasherLoc（630N）、Delta（430N）和Retroscrew（285N）。Intrafix装置在腘绳肌移植物固定于胫骨方面表现出卓越的强度。WasherLoc紧随其后。
