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Ligament graft initial fixation strength using biodegradable interference screws.

S Rupp1, R Seil, A Schneider

  • 1Department of Orthopaedic Surgery, University Hospital, University of Saarland, Homburg/Saar, Germany.

Journal of Biomedical Materials Research
|February 24, 1999
PubMed
Summary
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Biodegradable interference screws show promising initial fixation strength for anterior cruciate ligament reconstruction. These screws may offer a viable alternative to traditional titanium screws, potentially enabling faster patient rehabilitation.

Area of Science:

  • Orthopedic Surgery
  • Biomaterials Science
  • Biomechanics

Background:

  • Anterior cruciate ligament (ACL) reconstruction commonly uses interference screws for graft fixation.
  • Titanium interference screws are standard, but biodegradable alternatives are emerging.
  • Evaluating the primary fixation strength of biodegradable screws is crucial for clinical adoption.

Purpose of the Study:

  • To compare the initial fixation strength of three types of biodegradable interference screws against a titanium screw.
  • To assess the suitability of biodegradable screws for accelerated rehabilitation protocols in ACL reconstruction.

Main Methods:

  • A biomechanical study using porcine lower limbs to evaluate interference screw fixation strength.
  • Three biodegradable screws (polyglycolic acid, poly-L-lactic acid) and one titanium screw were tested.

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  • Specimens were loaded to failure, with bone mineral density measured to control for bias.

    • Main Results:

    • The Linvatec biodegradable screw demonstrated the highest load to failure (844 N), comparable to the titanium screw (785 N).
    • The titanium screw and Linvatec screw showed significantly higher fixation strength than Acufex and Arthrex screws.
    • No significant difference in bone mineral density was observed between groups.

    Conclusions:

    • All tested biodegradable interference screws exhibited sufficient primary fixation strength for accelerated rehabilitation after ACL reconstruction.
    • Biodegradable screws present a potentially effective alternative to titanium screws, offering comparable biomechanical performance.
    • Further clinical evaluation is warranted to confirm the long-term efficacy and safety of these biodegradable options.