Costa Rogério Nascimento, Nadal Rubens Rosso, Saggin Paulo Renato Fernandes, Lopes Junior Osmar Valadão, Spinelli Leandro de Freitas, Israel Charles Leonardo
Serviço de Cirurgia do Joelho, Hospital São Vicente de Paulo, Passo Fundo, RS, Brasil.
Laboratório de Bioengenharia, Biomecânica e Biomateriais, Universidade de Passo Fundo, Passo Fundo, RS, Brasil.
Rev Bras Ortop (Sao Paulo). 2019 Apr;54(2):183-189. doi: 10.1016/j.rbo.2017.09.001. Epub 2019 May 10.
The present study aims to evaluate different methods of tibial fixation in the reconstruction of the anterolateral ligament (ALL). In addition, the present paper aims to compare the effectiveness of these methods and their mechanisms of failure in swine knees. A total of 40 freshly frozen swine limbs were divided into 4 groups of 10 specimens, according to the tibial fixation technique used. In group A, the tibial fixation of the tendon graft was made through an anchor passing the graft. In group B, the tibial fixation was performed through a metal interference screw in a single bone tunnel. In group C, the tibial fixation included an anchor associated with a tendinous suture (but not with a wire crossing the tendon). In group D, two confluent bony tunnels were drilled and combined with an interference screw in one of them. The lowest mean force (70.56 N) was observed in group A, and the highest mean force (244.85 N) was observed in group B; the mean values in the other 2 groups ranged from 171.68 N (group C) to 149.43 N (group D). Considering the margin of error (5%), there was a significant difference between the groups ( < 0.001). Fixation with an interference screw in a single tunnel bone showed the highest tensile strength among the evaluated techniques.
本研究旨在评估前外侧韧带（ALL）重建术中不同的胫骨固定方法。此外，本文旨在比较这些方法在猪膝关节中的有效性及其失效机制。
总共40个新鲜冷冻的猪肢体根据所使用的胫骨固定技术分为4组，每组10个标本。A组中，肌腱移植物的胫骨固定通过穿过移植物的锚钉进行。B组中，通过单骨隧道内的金属挤压螺钉进行胫骨固定。C组中，胫骨固定包括一个与肌腱缝线相关的锚钉（但不与穿过肌腱的钢丝相关）。D组中，钻出两个汇合的骨隧道，并在其中一个隧道中结合挤压螺钉。
A组观察到的平均力最低（70.56 N），B组观察到的平均力最高（244.85 N）；其他两组的平均值介于171.68 N（C组）至149.43 N（D组）之间。考虑到误差范围（5%），各组之间存在显著差异（<0.001）。
在评估的技术中，单隧道骨内使用挤压螺钉固定显示出最高的拉伸强度。
