Biomechanical comparisons of current suspensory fixation devices for anterior cruciate ligament reconstruction

Jin, Cheng; Paluvadi, Siddhartha Venkata; Lee, Sung-Jae; Yoo, Seung-Jin; Song, Eun-Kyoo; Seon, Jong Keun

doi:10.1007/s00264-018-3780-7

Cited by 28 publications

(18 citation statements)

References 10 publications

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“…1 In a recent study comparing UB with 2 other ALDs (RigidLoop Adjustable and ProCinch RT), after 5000 cycles, UB showed the largest elongation at failure, although all 3 demonstrated elongations <3 mm over an extended number of cycles at high loads. 36 However, Cheng et al 8 observed that the mechanical properties of the GraftMax ALD were comparable with those of TR.…”

Section: Discussionmentioning

confidence: 99%

In Vitro Testing of 2 Adjustable-Loop Cortical Suspensory Fixation Systems Versus Interference Screw for Anterior Cruciate Ligament Reconstruction

Garcés

Fuentes

Yáñez

et al. 2021

Orthopaedic Journal of Sports Medicine

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Background: It is not clear whether the mechanical strength of adjustable-loop suspension devices (ALDs) in anterior cruciate ligament (ACL) reconstruction is device dependent and if these constructs are different from those of an interference screw. Purpose: To compare the biomechanical differences of 2 types of ALDs versus an interference screw. Study Design: Controlled laboratory study. Methods: ACL reconstruction was performed on porcine femurs and bovine extensor tendons with 3 types of fixation devices: interference screw, UltraButton (UB) ALD, and TightRope (TR) ALD (n = 10 for each). In addition to specimen testing, isolated testing of the 2 ALDs was performed. The loading protocol consisted of 3 stages: preload (static 150 N load for 5 minutes), cyclic load (50-250 N at 1 Hz for 1000 cycles), and load to failure (crosshead speed 50 mm/min). Displacement at different cycles, ultimate failure load, yield load, stiffness, and failure mode were recorded. Results: In specimen testing, displacement of the ALDs at the 1000th cycle was similar (3.42 ± 1.34 mm for TR and 3.39 ± 0.92 mm for UB), but both were significantly lower than that of the interference screw (7.54 ± 3.18 mm) ( P < .001 for both). The yield load of the UB (547 ± 173 N) was higher than that of the TR (420 ± 72 N) ( P = .033) or the interference screw (386 ± 51 N; P = .013), with no significant difference between the latter 2. In isolated device testing, the ultimate failure load of the TR (862 ± 64 N) was significantly lower than that of the UB (1879 ± 126 N) ( P < .001). Conclusion: Both ALDs showed significantly less displacement in cyclic loading at ultimate failure than the interference screw. The yield load of the UB was significantly higher than that of the other 2. The ultimate failure occurred at a significantly higher load for UB than it did for TR in isolated device testing. Clinical Relevance: Both UB and TR provided stronger fixation than an interference screw. Although difficult to assess, intrinsic differences in the mechanical properties of these ALDs may affect clinical outcomes.

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Section: Discussionmentioning

confidence: 99%

In Vitro Testing of 2 Adjustable-Loop Cortical Suspensory Fixation Systems Versus Interference Screw for Anterior Cruciate Ligament Reconstruction

Garcés

Fuentes

Yáñez

et al. 2021

Orthopaedic Journal of Sports Medicine

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“…They concluded that it is possible to improve the designs of biodegradable interference screws for greater torque to be applied and greater screw fi xation between host bone and the graft for better integration, better patient healing, and improved patient outcomes [107]. properties of the GraftMax® with the EndoButton® and TightRope® to investigate whether knotting the free end of latter could improve biomechanical properties [105]. The study of Abdullah, et al shows that the maximum von Mises stress that occurs on interference screws is less than 40 MPa at the femoral and tibial fi xation [104].…”

Section: Fixation Techniques and Devicesmentioning

confidence: 99%

“…Scientifi c advances have been made and we have more knowledge on the anatomical, biological and biomechanical issues regarding the incorporation of grafts, new fi xation devices, materials and techniques, as well as more effective and faster rehabilitation devices and protocols. Literature puts in evidence three main topics of research on ACLR: surgery, biomechanics and clinical outputs ; types of grafts (autograft versus allograft versus synthetic grafts, Hamstring Tendon (HT) versus Patellar Tendon (PT) versus Quadriceps Tendon (QT) and single bundle versus double bundle) and tunnel geometry and orientation ; and fi xation techniques and devices [103][104][105][106][107][108][109]. Other issues have also been addressed such as rehabilitation programs [6,21,44,54], tunnel drilling and thermal necrosis [55,57,110], bone remodeling/healing [36,42], virtual simulation [7,22,27,68] and specifi c Finite Element Analysis (FEA) [31,77].…”

Section: Introductionmentioning

confidence: 99%

A review on finite element analysis of the anterior cruciate ligament reconstruction

Simões¹,

Ramos²,

Oliveira³

et al. 2021

Open J Orthop Rheumatol

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A signifi cant number of papers relatively to the investigation made on Anterior Cruciate Ligament (ACL) Reconstruction (ACLR) has been published in orthopaedic related journals. Finite Element (FE) Analysis (FEA) has been used to predict the performance of biomechanical-biomedical systems as well as the effect of clinical factors on the ACLR success. This research tool presents some advantages relatively to experimental studies in assessing stresses and strains in soft tissues of the knee joint. By interpreting correctly FE results, it is possible to extrapolate them to clinical situations. This article reviews papers published from 2016 until nowadays on FEA for ACLR studies searched in Google Scholar, Medline and PubMed databases. Only studies that addressed surgery techniques, type and size of grafts, tunnel geometry and orientation, and fi xation devices are reviewed and presented.

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“…7 The study by Chang et al 1 was published online ahead of print on November 13, 2017, and therefore was included in our search up to November 20, 2017. The other 2 articles 2,6 published in 2018 and mentioned in the letter were not published online before our search date. The articles by Kamelger et al 4 and Noonan et al 5 were not included in our systematic review, as their biomechanical testing protocols differed substantially from the included studies.…”

mentioning

confidence: 99%

Systematic Review of Fixed- Versus Adjustable-Loop Femoral Cortical Suspension Devices for Anterior Cruciate Ligament Reconstruction: Response

Houck

Kraeutler

McCarty

et al. 2019

Orthopaedic Journal of Sports Medicine

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Biomechanical comparisons of current suspensory fixation devices for anterior cruciate ligament reconstruction

Abstract: The biomechanical properties of the GraftMax are comparable to the TightRope. The TightRope, when knotted, shows an improvement both in load to failure and cyclic displacement, though the differences are not significant.

Cited by 28 publications

References 10 publications

In Vitro Testing of 2 Adjustable-Loop Cortical Suspensory Fixation Systems Versus Interference Screw for Anterior Cruciate Ligament Reconstruction

In Vitro Testing of 2 Adjustable-Loop Cortical Suspensory Fixation Systems Versus Interference Screw for Anterior Cruciate Ligament Reconstruction

A review on finite element analysis of the anterior cruciate ligament reconstruction

Systematic Review of Fixed- Versus Adjustable-Loop Femoral Cortical Suspension Devices for Anterior Cruciate Ligament Reconstruction: Response

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