Primary stability of bone-patellar tendon-bone graft fixation with biodegradable pins

Weimann, André; Zantop, Thore; Rümmler, Markus; Hassenpflug, J.; Petersen, Wolf

doi:10.1016/j.arthro.2003.10.023

Cited by 24 publications

(32 citation statements)

References 27 publications

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“…Initial fixation strength of the graft should greatly exceed these values to make safe rehabilitation possible during the first 6 weeks. Many studies and reviews on ACL [27,28]. A possible explanation for these differences is the fact that both studies pulled their grafts from fresh (frozen) bovine tibia and used cross-pin fixation.…”

Section: Discussionmentioning

confidence: 99%

Failure load of patellar tendon grafts at the femoral side: 10- versus 20-mm-bone blocks

Meuffels

Niggebrugge

Verhaar

2008

Knee Surg Sports Traumatol Arthrosc

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The aim of the study was to investigate whether use of short bone blocks is safe in anterior cruciate ligament (ACL) reconstruction. Our hypothesis was that the smaller 10-mm-length bone blocks will fail at lower loads than 20-mm-bone blocks. Ten paired human cadaver knees were randomly assigned to the 10-or 20-mm group (group 1 and 2) and underwent bone-patellar tendon-bone femoral fixation with interference screw. Tensile tests were performed using a tensile testing machine (Instron). Stiffness, failure load and failure mode were recorded. Median stiffness was 72 N/mm (16-103) for 10-mm-bone blocks and 91 N/mm (40-130) for 20-mm-bone blocks. Median failure loads were 402 N (87-546) for 10-mm-long bone block and 456 N (163-636) for 20-mm-bone blocks. There was no statistically significant difference between groups (P = 0.35). All bone-patellar tendon-bone grafts were pulled out of the femoral tunnel with interference screw, due to slippage. We concluded that a 10-mm-long bone block was not significantly weaker than a 20-mm-long bone block. Failure loads of a 10-mm-bone block exceeded loading values at passive and active extension of the knee under normal conditions. Ten millimetre bone blocks offered sufficient fixation strength in ACL reconstruction.

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Section: Discussionmentioning

confidence: 99%

Failure load of patellar tendon grafts at the femoral side: 10- versus 20-mm-bone blocks

Meuffels

Niggebrugge

Verhaar

2008

Knee Surg Sports Traumatol Arthrosc

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“…Displacement under cyclic loading was least for a titanium interference screw and greatest for a biodegradable interference screw. It has been estimated that anterior cruciate ligament grafts experience between 30‐ and 400‐N loading during rehabilitation 30. Therefore, bonding of soft‐tissue anchoring devices through the BoneWelding technology may improve the relative performance of resorbable materials for such applications.…”

Section: Discussionmentioning

confidence: 99%

Enhancing the mechanical integrity of the implant–bone interface with BoneWelding® technology: Determination of quasi‐static interfacial strength and fatigue resistance

Ferguson

Weber²,

Rechenberg

et al. 2005

J Biomed Mater Res

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The BoneWelding technology is an innovative bonding method, which offers new alternatives in the treatment of fractures and other degenerative disorders of the musculoskeletal system. The BoneWelding process employs ultrasonic energy to liquefy a polymeric interface between orthopaedic implants and the host bone. Polymer penetrates the pores of the surrounding bone and, following a rapid solidification, forms a strong and uniform bond between implant and bone. Biomechanical testing was performed to determine the quasi-static push-out strength and fatigue performance of 3.5-mm-diameter polymeric dowels bonded to a bone surrogate material (Sawbones solid and cellular polyurethane foam) using the BoneWelding process. Fatigue tests were conducted over 100,000 cycles of 20-100 N loading. Mechanical test results were compared with those obtained with a comparably-sized, commercial metallic fracture fixation screw. Tests in surrogate bone material of varying density demonstrated significantly superior mechanical performance of the bonded dowels in comparison to conventional bone screws (p < 0.01), with holding strengths approaching 700 N. Even in extremely porous host material, the performance of the bonded dowels was equivalent to that of the bone screws. For both cellular and solid bone analog materials, failure always occurred within the bone analog material surrounding and distant to the implant; the infiltrated interface was stronger than the surrounding bone analog material. No significant decrease in interfacial strength was observed following conditioning in a physiological saline solution for a period of 1 month prior to testing. Ultrasonically inserted implants migrated, on average, less than 20 microm over, and interfacial stiffness remained constant the full duration of fatigue testing. With further refinement, the BoneWelding technology may offer a quicker, simpler, and more effective method for achieving strong fixation and primary stability for fracture fixation or other orthopaedic and dental implant applications.

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“…However, a number of disadvantages of interference screws, including screw divergence or graft damage, have led to the development of other fi xation approaches ( 2 ). In biomechanical analysis, femoral graft fi xation with bioabsorbable cross pins has been shown to be a technique that provides pullout strength comparable to that obtained with other fi xation devices ( 3,4 ). Several studies ( 5-9 ) on the clinical outcome of bioabsorbable cross-pin fi xation techniques have yielded promising results.…”

Section: Patient Selection and Clinical Evaluationmentioning

confidence: 99%

Anterior Cruciate Ligament Reconstruction by Using Bioabsorbable Femoral Cross Pins: MR Imaging Findings at Follow-up and Comparison with Clinical Findings

Studler¹,

White²,

Naraghi³

et al. 2010

Radiology

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Primary stability of bone-patellar tendon-bone graft fixation with biodegradable pins

Cited by 24 publications

References 27 publications

Failure load of patellar tendon grafts at the femoral side: 10- versus 20-mm-bone blocks

Failure load of patellar tendon grafts at the femoral side: 10- versus 20-mm-bone blocks

Enhancing the mechanical integrity of the implant–bone interface with BoneWelding® technology: Determination of quasi‐static interfacial strength and fatigue resistance

Anterior Cruciate Ligament Reconstruction by Using Bioabsorbable Femoral Cross Pins: MR Imaging Findings at Follow-up and Comparison with Clinical Findings

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