Purpose
The aim of this study was to compare the initial fixation strength of tendon grafts
between different sizes of bioabsorbable interference screws (BioScrew; Linvatec,
Largo, FL) with bioabsorbable bead (EndoPearl; Linvatec) augmentation through biomechanical
analysis of a porcine femoral bone model.
Methods
Forty pairs of porcine femurs and porcine flexor digitorum profundus tendons were
divided into control and study groups. In the control group 8 × 30–mm BioScrews alone
(n = 10) were inserted, whereas different sizes of BioScrews, measuring 7 × 30 mm
(n = 10), 8 × 30 mm (n = 10), and 9 × 30 mm (n = 10), with 8–mm EndoPearl augmentation
were inserted individually for fixation of tendon grafts in the study groups. All
specimens were cyclically loaded with axial forces between 50 and 250 N at 1 Hz for
3,000 cycles and then incrementally loaded to failure at a rate of 150 mm/min.
Results
BioScrews with EndoPearl augmentation had a significantly higher failure load than
BioScrews alone (8–mm BioScrew alone v 8–mm BioScrew and EndoPearl, P < .05). There were no significant differences in the ultimate failure load (8 mm
v 7 mm and 9 mm, P = .201 and P = .871, respectively), stiffness (8 mm v 7 mm and 9 mm, P = .789 and P = .823, respectively), displacement (8 mm v 7 mm and 9 mm, P = .695 and P = .781, respectively), and bone mineral density (P = .728 for all comparisons) except insertion torque (8 mm v 7 mm and 9 mm, P = .045 and P = .518, respectively) between study groups. Less tendon laceration by the screw thread
was noted in the group in which smaller-sized BioScrews were used.
Conclusions
When EndoPearl augmentation was used, smaller-sized BioScrews (BioScrew size 1 mm
smaller than bone tunnel) offered equivalent graft fixation strength to BioScrews
of similar or larger sizes.
Clinical Relevance
Smaller-sized BioScrews can be chosen if EndoPearl augmentation has been used, and
EndoPearl augmentation may reduce the risk of tendon rupture while BioScrews are inserted.
Key Words
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Article info
Publication history
Accepted:
May 22,
2009
Received:
March 25,
2008
Footnotes
The authors report no conflict of interest.
Identification
Copyright
© 2009 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
