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Biomechanical Comparison of 3 Adjustable-Loop Suspensory Devices for All-Inside ACL Reconstruction: A Time-Zero
Samuel Bachmaier1, Edoardo Monaco2, Patrick A Smith3
1Arthrex Department of Orthopedic Research, Munich, Germany.
Orthopaedic Journal of Sports Medicine
|October 3, 2023
Summary
Adjustable-loop devices (ALDs) for anterior cruciate ligament reconstruction (ACLR) showed varying stability. The dual-locking device (DLD) best limited elongation, while the button-locking device (BLD) had lower failure loads, impacting ACLR outcomes.
Area of Science:
- Orthopedic surgery
- Biomedical engineering
- Sports medicine
Background:
- Stability of adjustable-loop devices (ALDs) in anterior cruciate ligament reconstruction (ACLR) is not well understood.
- ALDs are crucial for graft fixation in ACLR procedures.
Purpose of the Study:
- To evaluate the stabilization behavior of three distinct ALDs for all-inside ACLR.
- To compare their performance using a simulated surgical technique.
Main Methods:
- Three ALDs (Ultrabutton, Infinity, TightRope II) were tested with bovine tendon grafts.
- Constructs underwent cyclic loading and pull-to-failure tests.
- Measurements included construct elongation, stiffness, and ultimate load.
Main Results:
- The dual-locking device (DLD) demonstrated the least initial and total elongation.
- The suture-locking device (SLD) exhibited the highest dynamic elongation and exceeded the clinical failure threshold.
- The button-locking device (BLD) showed significantly lower failure loads compared to SLD and DLD.
Conclusions:
- The DLD effectively limited critical construct elongation, outperforming other devices.
- SLD and BLD showed limitations in stability and failure load, respectively.
- Understanding ALD biomechanics is vital for improving ACLR outcomes.
