A biomechanical comparison of steel screws versus PLLA and magnesium screws for the Latarjet procedure.

Autor: Bockmann B; Department of Orthopaedics and Trauma Surgery, St. Josef Hospital, Ruhr University Bochum, Gudrunstrasse 56, 44791, Bochum, Germany. maik-benjamin.bockmann@ruhr-uni-bochum.de.; Department of Sports Orthopaedics, St. Vinzenz Hospital, Schloßstraße 85, Düsseldorf, Germany. maik-benjamin.bockmann@ruhr-uni-bochum.de., Jaeger E; Department of Orthopaedics and Traumatology, Medical University of Innsbruck, Innsbruck, Austria., Dankl L; Department of Orthopaedics and Traumatology, Medical University of Innsbruck, Innsbruck, Austria., Nebelung W; OPND-Praxisklinik, Plange Mühle 4, Düsseldorf, 40221, Germany., Frey S; Department of Orthopedic, Trauma- and Handsurgery, Florence-Nightingale-Hospital, Düsseldorf, Germany., Schmölz W; Department of Orthopaedics and Traumatology, Medical University of Innsbruck, Innsbruck, Austria., Schulte TL; Department of Orthopaedics and Trauma Surgery, St. Josef Hospital, Ruhr University Bochum, Gudrunstrasse 56, 44791, Bochum, Germany.
Jazyk: angličtina
Zdroj: Archives of orthopaedic and trauma surgery [Arch Orthop Trauma Surg] 2022 Jun; Vol. 142 (6), pp. 1091-1098. Date of Electronic Publication: 2021 Apr 30.
DOI: 10.1007/s00402-021-03898-w
Abstrakt: Introduction: The fixation of the coracoid process onto the glenoid is an important step of the Latarjet procedure, and implant-associated complications are a relevant and severe problem. This study compares the fixation strength and failure mode of two biodegradable materials with stainless-steel screws.
Methods: 24 Fresh-frozen cadaveric scapulae were divided into three groups of equal size and received a coracoid transfer. Cadavers were matched according to their bone mineral density (BMD). In group 1, small-fragment screws made of stainless steel were used. In the second group, magnesium screws were used, and in the third group, screws consisted of polylactic acid (PLLA). A continuously increasing sinusoidal cyclic compression force was applied until failure occurred, which was defined as graft displacement relative to its initial position of more than 5 mm.
Results: At 5-mm displacement, the axial force values showed a mean of 374 ± 92 N (range 219-479 N) in group 1 (steel). The force values in group 2 (magnesium) had a mean of 299 ± 57 N (range 190-357 N). In group 3 (PLLA), failure occurred at 231 ± 83 N (range 109-355 N). The difference between group 1 (steel) and group 2 (magnesium) was not statistically significant (P = 0.212), while the difference between group 1 (steel) and group 3 (PLLA) was significant (P = 0.005).
Conclusion: Stainless-Steel screws showed the highest stability. However, all three screw types showed axial force values of more than 200 N. Stainless steel screws and PLLA screws showed screw cut-out as the most common failure mode, while magnesium screws showed screw breakage in the majority of cases.
Evidence: Controlled laboratory study.
(© 2021. The Author(s).)
Databáze: MEDLINE
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