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Bone ingrowth into open architecture PEEK interference screw after ACL reconstruction.

Martin Lind1, Torsten Nielsen2, Ole Gade Sørensen2

  • 1Department of Orthopedics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark. martinlind@dadlnet.dk.

Journal of Experimental Orthopaedics
|September 19, 2020
PubMed
Summary

Open architecture interference screws show promising bone ingrowth after anterior cruciate ligament reconstruction (ACLR). At 12 months, 42% of implants had over 10% bone ingrowth, indicating improved healing potential.

Keywords:
ACL reconstructionBone ingrowthGraft fixationInterference screw

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Area of Science:

  • Orthopedic surgery
  • Biomaterials science
  • Radiology

Background:

  • Open or fenestrated interference screw designs aim to enhance bone healing and graft integration in anterior cruciate ligament reconstruction (ACLR).
  • This study investigates bone ingrowth into novel open architecture interference screws.
  • The use of polyetheretherketone (PEEK) in orthopedic implants offers biocompatibility and radiolucency.

Purpose of the Study:

  • To evaluate bone ingrowth into open architecture interference screws within the tibial tunnel after ACLR using CT scanning.
  • To assess the hypothesis that open architecture interference screws promote bone ingrowth into their cavities.
  • To determine the safety and efficacy of these screws in soft tissue ACL reconstruction.

Main Methods:

  • Twelve patients underwent arthroscopic ACLR using semitendinosus-/gracilis tendon grafts and open architecture PEEK interference screws.
  • Patients were scanned using multi-slice CT at two weeks, six months, and twelve months postoperatively.
  • Bone ingrowth was quantified on CT scans, alongside clinical outcomes including IKDC scores and knee laxity measurements.

Main Results:

  • No significant bone ingrowth (>10%) was observed at six months.
  • By twelve months, 42% of implants showed over 10% bone ingrowth (p=0.009), with an average bone filling of 7.7%.
  • No tunnel widening or cyst formation occurred; clinical outcomes (IKDC score, knee laxity) improved significantly, with no serious adverse events reported.

Conclusions:

  • Open architecture PEEK interference screws can stimulate bone ingrowth after soft tissue ACL reconstruction, with 7.7% average bone filling at 12 months.
  • The screw design appears safe and does not compromise tunnel integrity.
  • Clinical outcomes in terms of knee stability and function are comparable to those reported in larger ACLR studies.