Cyclic testing of tibialis tendon allografts for anterior cruciate ligament reconstruction using suture-post versus spiked washer tibial fixation.

Autor: Markolf KL; Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, 76-143 CHS, Los Angeles, CA 90095, USA. Electronic address: kmarkolf@mednet.ucla.edu., Wang D; Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, 76-143 CHS, Los Angeles, CA 90095, USA., Joshi NB; Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, 76-143 CHS, Los Angeles, CA 90095, USA., Cheung E; Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, 76-143 CHS, Los Angeles, CA 90095, USA., Petrigliano FA; Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, 76-143 CHS, Los Angeles, CA 90095, USA., McAllister DR; Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, 76-143 CHS, Los Angeles, CA 90095, USA.
Jazyk: angličtina
Zdroj: Clinical biomechanics (Bristol, Avon) [Clin Biomech (Bristol, Avon)] 2019 Dec; Vol. 70, pp. 8-15. Date of Electronic Publication: 2019 Jul 23.
DOI: 10.1016/j.clinbiomech.2019.07.025
Abstrakt: Background: The purpose of this study was to directly compare spiked washer and suture-post tibial-sided fixation techniques used for anterior cruciate ligament reconstruction by measuring anterior tibial translation during cyclic tests.
Methods: Fresh-frozen human knees were tested using a robotic system that applied 250 cycles of anterior-posterior tibial force (134 N) at 30° flexion, while recording tibial translation. Ten intact knees were tested to collect baseline data for native specimens. A single knee was selected to test ligament reconstructions using doubled tibialis tendon allografts. All grafts were fixed proximally using an EndoButton™, and the tibial end of the graft was fixed with either a spiked washer or with a suture post placed at two different locations (near and distant) relative to the tibial tunnel.
Findings: Mean first cycle translation for intact knees was 4.8 (sd 1.8) mm; means after reconstruction were 2.6 (sd 0.9) mm (spiked washer), 10.1 (sd 1.9) mm (suture post near), and 10.4 (sd 1.5) mm (suture post distant). Corresponding means for translation increase over 250 cycles were 0.3 (sd 0.2) mm, 3.6 (sd 1.3) mm, 7.2 mm (sd 0.9) mm, and 8.0 (sd 1.3) mm. All mean increases (first cycle and cyclic) after ACL reconstruction were significantly greater than those for the intact knees, and all means with a suture post were significantly greater than those with a spiked washer. There were no significant differences between mean translations for near and distant suture post locations.
Interpretation: Use of suture post fixation for anterior cruciate ligament reconstruction is questioned since increases in anterior tibial translation could lead to excessive post-operative knee laxity and possibly early clinical failure.
(Copyright © 2019 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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