Letsch R, Garcia-Schürmann J M
Abteilung für Unfallchirurgie, Universitätsklinikum Essen.
Unfallchirurgie. 1993 Apr;19(2):74-80. doi: 10.1007/BF02588085.
One of the weak points of augmentation or replacement of cruciate ligaments by synthetic material is the fixation of these artificial ligaments to the bone. The present investigation examines the mechanical properties of a newly developed anchoring technique (ligament fixation device = LFD) in regard to linear and maximum load, stiffness, creep, and long-term durability compared to single staples, double staples in belt buckle technique, and passing the ligament through an additional bone tunnel. The tests are carried out on cadaver knees and plastic bones under standardized conditions with the same artificial ligament in all experiments (Trevira hochfest). The LFD shows a linear load of 1866 N in cadaver knees and 1874 N in plastic bones. The stiffness is 68.3 N/mm respectively 51.9 N/mm, the elongation at 500 N load 12.7 mm respectively 10.9 mm. In the hysteresis tests with submaximum loads the ligament/LFD-unit lasts 8515 cycles in the plastic bone and 4431 cycles in the cadaver knee. These results are significantly superior to all other fixation techniques concerning linear load, stiffness and long-term durability. They permit aggressive functional treatment and immediate postoperative weight bearing of the operated knee.