Suspension button constructs restore posterior knee laxity in solid tibial avulsion of the posterior cruciate ligament
| Autor: | Andreas Schmitt, Patrizia Lutz, Rainer Burgkart, Julian Mehl, Philipp Forkel, Jan J Lang, Andreas B. Imhoff, Matthias J. Feucht, Louis Buchmann |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Knee Joint Swine medicine.medical_treatment Bone Screws Tibial avulsion Osteotomy Posterior knee laxity Avulsion Load to failure medicine Animals Knee Orthopedics and Sports Medicine Suspension (vehicle) Orthodontics Tibia business.industry Stiffness equipment and supplies musculoskeletal system Biomechanical Phenomena ddc Suspension button medicine.anatomical_structure Knee laxity PCL Posterior cruciate ligament Orthopedic surgery Posterior Cruciate Ligament Surgery medicine.symptom business |
| Zdroj: | Knee Surgery, Sports Traumatology, Arthroscopy |
| Popis: | Purpose Dislocated tibial avulsions of the posterior cruciate ligament (PCL) require surgical intervention. Several arthroscopic strategies are options to fix the fragment and restore posterior laxity, including two types of suspension button devices: adjustable (self-locking) and rigid knotted systems. Our hypothesis was that a rigid knotted button construct has superior biomechanical properties regarding laxity restoration compared with an adjustable system. Both techniques were compared with standard screw fixation and the native PCL. Methods Sixty porcine knees were dissected. The constructs were tested for elongation, stiffness, yield force, load to failure force, and failure mode in a material testing machine. Group N (native, intact PCL) was used as a control group. In group DB (Dogbone™), TR (Tightrope™), and S (screw), a standardized block osteotomy with the osteotomized fragment attached to the PCL was set. The DB and TR groups simulated using a suspension button system with either a rigid knotted (DB) or adjustable system (TR). These groups were compared to a screw technique (S) simulating antegrade screw fixation from posterior. Results Comparing the different techniques (DB, TR, S), no significant elongation was detected; all techniques achieved a sufficient posterior laxity restoration. Significant elongation in the DB and TR group was detected compared with the native PCL (N). In contrast, screw fixation did not lead to significant elongation. The stiffness, yield load, and load to failure force did not differ significantly between the techniques. None of the techniques reached the same level of yield load and load to failure force as the intact state. Conclusion Arthroscopic suspension button techniques sufficiently restore the posterior laxity and gain a comparable construct strength as an open antegrade screw fixation. |
| Databáze: | OpenAIRE |
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