Cortical Tibial Press-Fit Fixation Demonstrates Comparable Biomechanical Performance With Interference Screw Fixation...

Area of Science:

• Orthopedic surgery
• Biomedical engineering
• Sports medicine

Background:

• The optimal graft and fixation method for anterior cruciate ligament reconstruction (ACLR) is debated.
• Cortical tibial press-fit fixation offers advantages like reduced cost and fewer implant-related complications.

Purpose of the Study:

• To compare the time-zero biomechanical properties of cortical tibial press-fit fixation versus interference screw fixation for bone-patellar tendon grafts in ACLR.
• To evaluate the potential clinical benefits of the press-fit technique.

Main Methods:

• A controlled laboratory study using 24 porcine knees.
• Grafts were fixed using either interference screws or implant-free cortical tibial press-fit.
• Biomechanical testing included cyclic loading and load-to-failure analysis.

Main Results:

• Both fixation methods demonstrated similar bone mineral density.
• No significant differences were found in cyclic displacement, stiffness, or ultimate load to failure.
• All specimens failed due to tendon avulsion or rupture.

Conclusions:

• Cortical tibial press-fit fixation provides adequate primary stability comparable to interference screws in a porcine ACLR model.
• This technique may be an effective option for ACLR.