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Related Experiment Videos

Cortical versus cancellous interference fixation for bone-patellar tendon-bone grafts

S Rupp1, R Seil, P W Krauss

  • 1Department of Orthopaedic Surgery, University Hospital, Homburg/Saar, Germany.

Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association
|July 29, 1998
PubMed
Summary

The position of metal interference screws impacts failure mode in anterior cruciate ligament reconstruction but not initial fixation strength. This study compared screw placement adjacent to the bone plug cortex versus between cancellous surfaces.

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Area of Science:

  • Orthopedic surgery
  • Biomechanical engineering
  • Sports medicine

Background:

  • Anterior cruciate ligament (ACL) reconstruction commonly uses bone-patellar tendon-bone grafts.
  • Metal interference screws are utilized for graft fixation.
  • Optimal screw placement for graft stability is critical.

Purpose of the Study:

  • To compare the initial fixation strength of metal interference screws based on their position relative to the bone plug in ACL reconstruction.
  • To analyze the influence of screw placement on graft failure modes.

Main Methods:

  • Porcine lower limbs were used for biomechanical testing.
  • Two groups were established: screw adjacent to bone plug cortex (Group 1) and screw between cancellous surfaces (Group 2).
  • Specimens underwent load-to-failure testing using a universal material testing machine.

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Main Results:

  • Initial fixation strength was not significantly different between the two groups (Group 1: 779 ± 179 N; Group 2: 743 ± 143 N).
  • Failure modes differed significantly: Group 1 showed predominantly tendon ruptures and bone plug fractures (70%), while Group 2 exhibited mainly bone plug pullouts (75%).

Conclusions:

  • Screw position relative to the bone plug affects the failure mode in ACL reconstruction.
  • Initial fixation strength is not significantly influenced by screw placement in this context.