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Interference screw fixation of free tendon grafts: significant time-dependent decrease of the initial contact forces.

Christian Stärke1, Ulrike Winkelmann2, Siegmar Glüge3

  • 1Department of Orthopedic Surgery, Otto-von-Guericke-University of Magdeburg, Leipziger Straße 44, 39120, Magdeburg, Germany. christian.staerke@med.ovgu.de.

Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA
|November 29, 2014
PubMed
Summary
This summary is machine-generated.

Contact forces in anterior cruciate ligament (ACL) surgery interference screw fixation decrease significantly over time. This relaxation, particularly in the first hour, impacts graft fixation strength and suggests backup fixation may be advisable.

Keywords:
ACLForceInterference screwStress relaxationTendon graft

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Area of Science:

  • Orthopedic surgery
  • Biomaterials science
  • Biomechanics

Background:

  • Interference screw fixation is standard for tendon grafts in ACL reconstruction.
  • Tendons and bone exhibit viscoelastic properties, influencing fixation stability over time.
  • The long-term effects of these properties on interference screw fixation forces are not fully understood.

Purpose of the Study:

  • To investigate the time-dependent behavior of contact forces in simulated interference screw fixation of tendon grafts.
  • To quantify the decrease in fixation strength over a 12-hour period.
  • To test the hypothesis that substantial force relaxation occurs.

Main Methods:

  • Simulated ACL graft fixation using pig tendons and artificial bone surrogates.
  • Investigated two fixation methods: screw insertion (A) and screw pressing (B).
  • Monitored contact forces over a 12-hour duration.

Main Results:

  • Initial contact forces were 1,299 N (A) and 2,156 N (B).
  • Forces significantly decreased to 530 N (A) and 461 N (B) after 12 hours (p < 0.001).
  • Over 80% of force relaxation occurred within the first hour.

Conclusions:

  • Significant relaxation of interference screw fixation forces occurs in ACL surgery.
  • This relaxation has implications for assessing fixation strength and clinical practice.
  • Initial fixation strength diminishes, potentially necessitating backup fixation methods.