Purpose: To compare the biomechanical properties of eccentrically positioned bioabsorbable
and titanium interference screws for quadrupled hamstring tendon graft (QHTG) fixation.
Type of Study: In vitro, biomechanical study. Methods: In 10 paired cadaveric tibiae and femurs (mean age, 66.5 years; range, 53 to 81 years),
QHTG fixation was performed in tunnels sized to within 0.5 mm of QHTG diameter using
either a titanium (RCI; Smith & Nephew Donjoy, Carlsbad, CA) or a bioabsorbable (BioScrew;
Linvatec, Largo, FL) screw of equal size. Constructs then underwent biomechanical
load-to-failure testing on a servo-hydraulic device at 20 mm/min. Results: Load at failure was greater for femoral-side QHTG fixation using the bioabsorbable
screw than the titanium screw (486 ± 223.7 N v 246 ± 99.1 N, P = .006); however, displacement did not differ (P = .81). There were no statistically significant differences between groups for tibial
side load at failure (P = .54), stiffness (P = .44), or displacement (P = .50). Screw thread-induced graft laceration was more frequently observed in the
titanium screw group (9 of 10 grafts during femoral-side testing, 0 of 10 grafts during
tibial-side testing) than in the bioabsorbable screw group (0 of 10 grafts during
femoral-side testing, 1 of 10 grafts during tibial-side testing). Conclusions: BioScrew interference screw fixation was comparable or superior to RCI titanium interference
screw fixation. BioScrew interference screw fixation also produced less screw thread-induced
laceration of the QHTG during load-to-failure testing. Clinical Relevance: Use of a biodegradable interference screw positioned directly against a soft-tisse
graft provides fixation properties similar to those of a metal interference screw.
Key Words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to ArthroscopyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Hamstring tendon grafts for reconstruction of the anterior cruciate ligament.J Bone Joint Surg Am. 1999; 81: 549-557
- Strength of the quadriceps femoris muscle and functional recovery after reconstruction of the anterior cruciate ligament. A prospective, randomized clinical trial of electrical stimulation.J Bone Joint Surg Am. 1995; 77: 1166-1173
- Graft fixation in cruciate ligament reconstruction. Current concepts.Am J Sports Med. 2000; 28: 764-774
- Arthroscopic reconstruction of the anterior cruciate ligament—A comparison of patellar tendon autograft and four-strand hamstring tendon autograft.Am J Sports Med. 1999; 27: 444-454
- A five-year comparison of patellar tendon versus four-strand hamstring tendon autograft for arthroscopic reconstruction of the anterior cruciate ligament.Am J Sports Med. 2002; 30: 523-536
- The influence of reverse-thread screw femoral fixation on laxity measurements after anterior cruciate ligament reconstruction with hamstring tendon.Am J Sports Med. 2000; 28: 695-699
- Replacement of the anterior cruciate ligament. Biomechanical studies of patellar and semitendinosus tendon fixation with a poly(D,L-lactide) interference screw.Unfallchirurg. 1999; 102: 115-123
- Endoscopic anterior cruciate ligament reconstruction.Arthroscopy. 1995; 11: 577-584
- Quadrupled semitendinosis-gracilis autograft fixation in the femoral tunnel.Arthroscopy. 1998; 14: 241-245
- Interference screw fixation strength of quadrupled hamstring tendon graft is directly related to bone mineral density and insertion torque.Am J Sports Med. 2000; 28: 705-710
- Biomechanical comparison between BioScrew and titanium alloy interference screws for bone-patellar tendon-bone graft fixation in anterior cruciate ligament reconstruction.Arthroscopy. 1997; 13: 229-232
- Correlation of bone tunnel diameter with quadrupled hamstring strength using a biodegradable interference screw.Arthroscopy. 2002; 18: 901-907
- Effects of unilateral strength training and detraining on bone mineral density and content in young women. A study of mechanical loading and deloading on human bones.Calcif Tissue Int. 1994; 55: 59-67
- Clinical outcome of anterior cruciate ligament reconstruction with quadrupled hamstring tendon graft and bioabsorbable interference screw fixation.Am J Sports Med. 2003; 31: 518-521
- MR imaging and metallic implants for anterior cruciate ligament reconstruction.J Magn Reson Imaging. 1992; 2: 225-228
- Serial magnetic resonance imaging evaluation of operative site after fixation of patellar tendon graft with bioabsorbable interference screws in anterior cruciate ligament reconstruction.Arthroscopy. 1999; 15: 709-718
- Anterior cruciate ligament reconstruction with bioabsorbable polyglycolic acid interference screws.Radiology. 2002; 225: 541-550
- Serial magnetic resonance imaging evaluation of a bioabsorbable interference screw and the adjacent bone.Arthroscopy. 1999; 15: 481-488
- Bioabsorbable polyglyconate interference screw fixation in anterior cruciate ligament reconstruction.Arthroscopy. 2000; 16: 491-498
Article info
Footnotes
Supported in part by Linvatec Inc, Largo, Florida.
Identification
Copyright
© 2005 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
