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Soft-tissue interference fixation: bioabsorbable screw versus metal screw.

Jeff C Brand¹, John Nyland, David N M Caborn

¹Alexandria Orthopaedics and Sports Medicine, Alexandria, Minnesota 56308, USA. bjbrand@rea-alp.com

Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association

|August 9, 2005

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Bioabsorbable interference screws offer comparable or superior fixation for quadrupled hamstring tendon grafts (QHTG) compared to titanium screws. They also reduce graft damage during fixation, improving QHTG biomechanical properties.

Area of Science:

Orthopedic surgery
Biomedical engineering
Sports medicine

Background:

Quadrupled hamstring tendon grafts (QHTG) are commonly used in anterior cruciate ligament (ACL) reconstruction.
Interference screw fixation is a standard method for securing QHTG.
The choice between bioabsorbable and titanium interference screws impacts graft fixation and integrity.

Purpose of the Study:

To compare the biomechanical properties of bioabsorbable and titanium interference screws for QHTG fixation.
To evaluate graft laceration associated with each screw type during fixation.

Main Methods:

In vitro biomechanical study using 10 paired cadaveric knees.
Quadrupled hamstring tendon grafts (QHTG) were fixed in femoral and tibial tunnels using either titanium or bioabsorbable interference screws.

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Constructs underwent load-to-failure testing.

Main Results:

Femoral-side fixation load at failure was significantly greater with bioabsorbable screws (486 N) than titanium screws (246 N).
No significant differences in tibial-side fixation strength, stiffness, or displacement were observed between screw types.
Screw thread-induced graft laceration was more frequent with titanium screws (90%) on the femoral side compared to bioabsorbable screws (0%).

Conclusions:

Bioabsorbable interference screws provide comparable or superior fixation strength for QHTG compared to titanium screws.
Bioabsorbable screws reduce the incidence of graft laceration during fixation.
Biodegradable interference screws offer a viable alternative to metal screws for soft-tissue graft fixation.