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Ultimate Load Measuring System for Fixation of Soft Tissue to Bone
Tatsuya Fujii1, Makoto Tateura1, Masato Ogawa1
1First Department of Orthopaedic Surgery, Dokkyo Medical University Saitama Medical Center, Koshigaya, Saitama, Japan.
Foot & Ankle International
|September 30, 2021
Summary
Three graft fixation methods for lateral ankle ligament reconstruction showed similar initial ultimate loads in an animal model. All methods demonstrated sufficient strength for clinical use, though failures occurred at the bone-ligament interface.
Area of Science:
- Orthopedic surgery
- Biomechanical engineering
- Sports medicine
Background:
- Graft fixation is crucial for lateral ankle ligament reconstruction.
- Comparing fixation methods requires a reproducible system.
- EndoButton (EB), interference screw (IFS), and socket anchoring (SA) are key techniques.
Purpose of the Study:
- To establish an experimental animal model for evaluating graft fixation.
- To compare the initial ultimate loads of EB, IFS, and SA techniques.
- To assess the suitability of these methods for lateral ankle ligament (LAL) reconstruction.
Main Methods:
- Porcine calcaneus and bovine Achilles tendons were used.
- Grafts were fixed using EB, IFS, and SA techniques in a simulated LAL injury model.
- Initial ultimate loads were measured using a tensile testing machine on 15 specimens per group.
Main Results:
- No statistically significant difference in ultimate loads was found among EB (223.6 ± 52.7 N), SA (229.7 ± 39.7 N), and IFS (208.8 ± 65.3 N) groups (P = .571).
- All tested fixation methods provided sufficient initial strength for clinical application.
- Failures consistently occurred at the bone-ligament substitute interface, primarily due to suture fixation.
Conclusions:
- SA, EB, and IFS techniques exhibit comparable initial ultimate loads in this experimental model.
- All three fixation methods are adequate for clinical use in LAL reconstruction.
- Suture fixation at the bone-ligament interface is a critical factor in failure modes.
