Interference screw fixation of soft tissue grafts in anterior cruciate ligament reconstruction: part 1: effect of tunnel compaction by serial dilators versus extraction drilling on the initial fixation strength.
| Autor: | Nurmi JT; Medical School and the Institute of Medical Technology, University of Tampere, Tampere, Finland., Kannus P, Sievänen H, Järvelä T, Järvinen M, Järvinen TL |
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| Jazyk: | angličtina |
| Zdroj: | The American journal of sports medicine [Am J Sports Med] 2004 Mar; Vol. 32 (2), pp. 411-7. |
| DOI: | 10.1177/0363546503261701 |
| Abstrakt: | Background: Compaction of the bone-tunnel walls by serial dilation is believed to enhance the interference screw fixation strength of the soft tissue grafts in anterior cruciate ligament (ACL) reconstruction. Hypothesis: Serial dilation enhances the fixation strength of soft tissue grafts in ACL reconstruction over extraction drilling. Study Design: Randomized experimental study. Methods: Initial fixation strength of the doubled anterior tibialis tendon grafts (fixed with a bioabsorbable interference screw) was assessed in 21 pairs of human cadaver tibiae with either serially dilated or extraction-drilled bone tunnels. The specimens were subjected to a cyclic-loading test, and those surviving were then tested using the single-cycle load-to-failure test. Results: During the cyclic-loading test, there were 3 fixation failures in the serially dilated and 6 failures in the extraction-drilled specimens but no significant stiffness or displacement differences between the groups. In the subsequent load-to-failure test, the average yield loads were 473 +/- 110 N and 480 +/- 115 N for the 2 groups respectively (P =.97) and no difference with regard to stiffness or mode of failure. Conclusions: Serial dilation does not increase the strength of interference fixation of soft tissue grafts in ACL reconstruction over extraction drilling. Clinical Relevance: The results of this experiment do not support the use of serial dilators in ACL reconstruction. |
| Databáze: | MEDLINE |
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