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Tendon transfer fixation: comparing a tendon to tendon technique vs. bioabsorbable interference-fit screw fixation
Eric Peter Sabonghy1, Robert Michael Wood, Catherine Glauber Ambrose
1Department of Orthopedics, The University of Texas Medical School at Houston, Houston, TX 77030, USA. psabonghy@hotmail.com
Foot & Ankle International
|June 10, 2003
Summary
This study compared foot and ankle tendon fixation methods. Tendon-to-tendon fixation showed greater strength than bioabsorbable screws in cadaver testing.
Area of Science:
- Orthopedic Surgery
- Biomechanics
- Foot and Ankle Surgery
Background:
- Tendon transfer surgery is crucial for treating foot and ankle pathologies like ruptures, deformities, and instabilities.
- Various fixation techniques exist, each with potential advantages and disadvantages regarding strength and clinical outcomes.
Purpose of the Study:
- To compare the biomechanical fixation strength of traditional tendon-to-tendon transfer techniques versus bioabsorbable interference-fit screw fixation in a fresh cadaver model.
- To evaluate the load at failure for each fixation method to inform surgical decision-making.
Main Methods:
- A fresh cadaver study utilizing 10 paired foot and ankle specimens.
- One specimen from each pair underwent tendon-to-tendon fixation, while the contralateral specimen received fixation with a 7 x 20-25 mm bioabsorbable interference-fit screw.
- Mechanical testing was performed to determine the load at failure for each fixation construct.
Main Results:
- Tendon-to-tendon fixation demonstrated a significantly higher average load at failure (279N ± 81N) compared to bioabsorbable screw fixation (148N ± 72N) (p = 0.0008).
- The bioabsorbable interference-fit screw fixation exhibited decreased strength relative to the traditional method in this cadaveric setting.
- Despite lower absolute strength, the mean fixation strength of the bioabsorbable screw (148N) may still offer adequate physiologic strength at the tendon-bone interface.
Conclusions:
- Traditional tendon-to-tendon fixation provides superior biomechanical strength compared to bioabsorbable interference-fit screws for foot and ankle tendon transfers in this cadaver model.
- While bioabsorbable screws offer less initial fixation strength, their load capacity may be sufficient for certain clinical applications in foot and ankle reconstruction.
- Further clinical studies are warranted to correlate these biomechanical findings with long-term patient outcomes and functional recovery.