Watson Jonathan N, McQueen Peter, Kim Walter, Hutchinson Mark R
University of Illinois at Chicago Department of Orthopaedic Surgery, Chicago, IL, United States.
Knee. 2015 Jun;22(3):256-61. doi: 10.1016/j.knee.2015.02.015. Epub 2015 Mar 17.
To report a case series of failures of bioabsorbable interference screws with possible identification of a novel failure mechanism.
A retrospective review of ACL reconstructions by the senior author utilizing BioComposite™ Interference Screws (Arthrex, Inc., Naples, FL) was performed. Complications related to screw placement, including fracture, breakage or bending were examined. Our rate and methods of failure were compared to those quoted in the current literature.
Eighty-seven patients of average age 23.8 years met inclusion criteria. There were eight screw failures in six patients, with femoral failure in seven and tibial failure in one. The femoral screw fractured halfway between the tip and head in five, while the head of the screw broke in one and the screw bent in another. In the case of tibial interference screw fracture, failure occurred halfway between the tip and head. The insertion device that was used was replaced after recognition of material deformation and considered a potential contributor to the breakage risk as no further screw failures have occurred since.
We demonstrate a unique failure mechanism of bio-absorbable interference screws. In each case, the reconstruction was salvaged. Regular inspection of materials and implants can ensure optimal outcomes and decrease complications intra-operatively.
报告一系列生物可吸收挤压螺钉失败的病例，并可能识别出一种新的失败机制。
对资深作者使用BioComposite™ 挤压螺钉（Arthrex公司，那不勒斯，佛罗里达州）进行的前交叉韧带重建手术进行回顾性研究。检查与螺钉置入相关的并发症，包括骨折、断裂或弯曲。将我们的失败率和失败方法与当前文献中引用的进行比较。
87例平均年龄23.8岁的患者符合纳入标准。6例患者出现8枚螺钉失败，其中7枚股骨侧失败，1枚胫骨侧失败。5枚股骨螺钉在尖端与头部之间的中间位置断裂，1枚螺钉头部断裂，另1枚螺钉弯曲。在胫骨挤压螺钉骨折的病例中，失败发生在尖端与头部之间的中间位置。在识别出材料变形后，更换了使用的置入装置，由于此后未再发生螺钉失败，因此认为其是导致断裂风险的潜在因素。
我们展示了生物可吸收挤压螺钉独特的失败机制。在每种情况下，重建手术均成功挽救。定期检查材料和植入物可确保术中获得最佳效果并减少并发症。
