OrthoCarolina Sports Medicine Center, 1915 Randolph Road, Charlotte, NC 28207, USA.
Atrium Health - Musculoskeletal Institute, 1025 Morehead Medical Drive, Charlotte, NC 28204, USA.
Knee. 2023 Mar;41:66-71. doi: 10.1016/j.knee.2022.12.005. Epub 2023 Jan 11.
The purpose of this study was to compare the biomechanical properties of a commercially available suture anchor and a screw post for supplemental tibial fixation of a bone-patellar tendon-bone (BTB) graft at time zero. We hypothesized that supplemental fixation using a suture anchor would demonstrate similar biomechanical performance in comparison with a screw post.
Sixteen fresh frozen, healthy human cadaveric knees underwent BTB autograft harvest, placement, and primary tibial-sided interference screw fixation using a standardized technique performed by a single surgeon. Specimens were randomly assigned to one of two tibial-sided supplemental fixation groups (suture anchor or screw post), yielding eight specimens in each group. Each specimen was affixed to a custom loading apparatus, with the tibial tunnel aligned in a vertical position that allowed for parallel "worst-case scenario" loading and eliminated loading variation due to tibial tunnel angle. Grafts were pretensioned to 30 N and biomechanical performance was compared with respect to cyclical loading between 50-250 N for 500 cycles at 0.5 Hz and pull-to-failure loading at 60 mm/min.
The suture anchor and screw post supplemental constructs demonstrated similar performance with respect to all biomechanical parameters assessed, including yield strength (294.0 N [IQR 267.2-304.2 N] versus 332.1 N [IQR 313.8-350.4 N]; P = 0.079) and ultimate strength (330.1 N [IQR 306.9-418.7 N] versus 374.7 N [IQR 362.0-387.3 N]; P = 0.3798). However, of the eight original specimens in each group, one suture anchor specimen (12.5%) and six metallic screw post specimens (75%) failed during cyclical testing and were unable to undergo displacement and load to failure testing.
This study provides preliminary evidence that supplemental tibial-sided fixation of a BTB ACL graft with a suture anchor has similar loading characteristics or load-to-failure strength when compared to supplemental fixation with a screw post construct.
Laboratory Controlled Study.
Basic Science Study.
本研究旨在比较商业上可获得的缝线锚钉与螺钉柱在零时刻对骨-髌腱-骨（BTB）移植物进行胫骨补充固定的生物力学性能。我们假设使用缝线锚钉进行补充固定在性能上与螺钉柱相似。
16 个新鲜冷冻的健康人体膝关节接受 BTB 自体移植物采集、放置和初级胫骨侧干扰螺钉固定，由一位外科医生采用标准化技术进行。标本被随机分配到胫骨侧补充固定组（缝线锚钉或螺钉柱）中的一个，每组有 8 个标本。每个标本都被固定在一个定制的加载装置上，胫骨隧道对齐在垂直位置，允许平行的“最坏情况”加载，并消除由于胫骨隧道角度引起的加载变化。移植物被预加载到 30N，并在 0.5Hz 下进行 50-250N 的循环加载和 60mm/min 的拉至失效加载，以比较生物力学性能。
缝线锚钉和螺钉柱补充构建物在所有评估的生物力学参数方面表现相似，包括屈服强度（294.0N [IQR 267.2-304.2N] 与 332.1N [IQR 313.8-350.4N]；P=0.079）和极限强度（330.1N [IQR 306.9-418.7N] 与 374.7N [IQR 362.0-387.3N]；P=0.3798）。然而，在每组的 8 个原始标本中，一个缝线锚钉标本（12.5%）和六个金属螺钉柱标本（75%）在循环测试中失效，无法进行位移和拉至失效测试。
本研究初步证明，与螺钉柱固定结构相比，缝线锚钉对 BTB ACL 移植物进行胫骨侧补充固定具有相似的加载特性或拉至失效强度。
实验室对照研究。
基础科学研究。
