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Related Experiment Videos

Hamstring tendon fixation using interference screws: a biomechanical study in calf tibial bone

A Weiler1, R F Hoffmann, A C Stähelin

  • 1Virchow Klinikum, Humboldt-University of Berlin, Germany.

Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association
|March 5, 1998
PubMed
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Biodegradable interference screws and hamstring tendon grafts with bone plugs significantly increase initial fixation strength for anterior cruciate ligament (ACL) reconstruction. This enhances graft stability and offers a promising alternative for knee surgery.

Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Sports Medicine

Background:

  • Optimal graft fixation in anterior cruciate ligament (ACL) reconstruction is near the native insertion site for enhanced anterior knee stability.
  • Hamstring tendon grafts secured with interference screws allow for this precise placement.
  • Previous research established titanium interference screws, but biodegradable options and bone plug inclusion require biomechanical evaluation.

Purpose of the Study:

  • To compare the initial pullout force, fixation stiffness, and failure modes of hamstring tendon grafts using biodegradable versus titanium interference screws.
  • To evaluate the biomechanical advantage of harvesting hamstring grafts with a distally attached tibial bone plug compared to direct tendon fixation.

Main Methods:

  • A biomechanical study involving 36 proximal calf tibiae.

Related Experiment Videos

  • Three-strand semitendinosus grafts were used with either biodegradable (poly-(D,L-lactide)) or titanium interference screws.
  • Grafts were harvested either with or without a distally attached tibial bone plug, creating four experimental groups.

    • Main Results:

    • Biodegradable interference screw fixation demonstrated significantly higher pullout force than titanium screws (Group I vs. III).
    • Grafts harvested with a bone plug exhibited significantly greater pullout force than those with direct tendon fixation (Group II & IV vs. I & III).
    • Biodegradable fixation consistently yielded higher pullout forces in both bone plug and direct tendon fixation scenarios.

    Conclusions:

    • Utilizing biodegradable interference screws can significantly improve the initial pullout strength of hamstring tendon grafts in ACL reconstruction.
    • Harvesting hamstring grafts with their distally attached tibial bone plug substantially increases initial fixation strength, offering a biomechanically advantageous technique.