Redesigning Metal Interference Screws Can Improve Ease of Insertion While Maintaining Fixation of Soft-Tissue Anterior Cruciate Ligament Reconstruction Grafts

Athwal, Kiron K.; Lord, Breck; Milner, Piers; Gutteridge, A.; Williams, Andy; Amis, Andrew A.

doi:10.1016/j.asmr.2020.01.004

Cited by 6 publications

(13 citation statements)

References 27 publications

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“…These studies evaluated what kind of impact the type of clamp had on the measurement [ 35 – 39 , 41 – 46 , 48 – 53 , 55 – 57 , 59 – 66 , 68 – 82 , 84 – 87 , 89 , 90 , 92 – 96 , 98 , 99 , 101 – 104 , 106 – 111 , 113 – 117 ].A variety of clamps for use during the endurance test of tendons were categorized according to the temperature used during the measurement. The clamps are divided into three groups: room temperature clamps [ 61 , 106 , 107 ] [ 35 , 37 – 39 , 41 , 44 – 46 , 48 , 49 , 51 – 53 , 55 – 57 , 59 , 62 , 64 , 70 , 72 , 75 , 77 – 80 , 84 , 85 , 87 , 89 , 90 , 92 – 94 , 96 , 98 , 99 , 101 – 103 , 109 – 111 , 115 – 117 ], cooled clamps (under room temperature with ice, cooled air, d...…”

Section: Resultsmentioning

confidence: 99%

“… How valuable is the research? Overall quality assessment Aeberhard 2019 [ 35 ] 1 1 1 1 1 1 1 1 1 1 high Aguila 2016 [ 36 ] 1 1 1 2 1 1 1 1 1 1 high Athwal 2020 [ 37 ] 1 1 1 1 1 1 1 1 1 1 high Awogni 2014 [ 38 ] 1 1 1 1 1 1 1 1 1 1 high Aynardi 2017 [ 39 ] 1 1 1 1 1 1 1 1 1 1 high Azar 2009 [ …”

Section: Methodsmentioning

confidence: 99%

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Categorize the existing clamps used for tensile test of human graft– a systematic review

Faragó

Kozma

Kiss

2022

BMC Musculoskelet Disord

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Background The use of tendon allografts for orthopedic repair has gained wide acceptance in recent years, most notably in anterior cruciate tendon reconstruction. Multiple studies support the use of tendon allografts and the benefits of its use are well accepted and understood. One of the important criteria of the use of tendon allografts is statistically similar histological and biomechanical properties to autographs. The aim of this systematic literature review is to investigate and categorize existing clamps used in the determination of the biomechanical properties of tendons such as maximum load, maximum strength, modulus of elasticity, ultimate strain, and stiffness. A variety of clamps for use during the endurance test of tendons were categorized according to the temperature used during the measurement. The clamps are divided into three groups: room temperature, cooled and heated clamps. The second goal of our review is to overview of clamps on the following aspects: name of clamp, author and date, type of clamps, type of endurance test (static or dynamic), type preloading (dynamic or static), type of tendon and measured and calculated parameters, and summarize in Table 3, as a comprehensive catalogue. Methods This systematic review was carried out in keeping with the PRISMA 2020 E&E and the PRISMA-S guidelines and checklists. A search was conducted for publications dating between 1991 and February 28th 2022 through three electronic databases (Web of Science, Scopus, and PubMed). We used Critical Appraisal Skills Program checklist to check the quality of included articles. Results The database search and additional sources resulted in 1725 records. 1635 records eliminated during the screening for various reasons (case report, other languages, book chapter, unavailable text/conference abstract, unrelated topic). The number of articles used in the final synthesis was 90. A variety of clamps for use during the endurance test of tendons were identified and categorized according to the temperature used during the measurement. Based on this, the clamps are divided into three groups: room temperature, cooled or heated clamps. Conclusions On the basis of the systematic literature review, mechanical parameters determined by usage with cooled clamps proved to be more reliable than with those at room temperature and with heated clamps. The collected information from the articles included name of clamp, author and date, type of clamps, type of endurance test (static or dynamic), type preloading (dynamic or static), type of tendon and measured and calculated parameters given in Table 3. summarized. The main advantage of the cooled clamps is that there is no limit to the type and length of the tendon. This study provides an overview of clamps and does not represent the modernity of any method.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Categorize the existing clamps used for tensile test of human graft– a systematic review

Faragó

Kozma

Kiss

2022

BMC Musculoskelet Disord

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“…The pitch and pitch depth parameters may not be a major factor influencing the fixation strengths since magnesium only had a pitch depth difference of 0.175 mm compared to the polymer screw but had significantly higher fixation strength. Moreover, the use of the same screw design with a modification of the tip significantly affected the fixation performance [ 11 ], implying the importance of the tip portion of the screw as well as the importance of its body slope. The shape of the polymer IS had a higher slope profile from the head to the tip of the screw than the magnesium screw; however, at the screw head, they shared the same diameter of 9 mm ( Figure 2 ).…”

Section: Discussionmentioning

confidence: 99%

“…The results found differences in fixation performance, but they were not statistically significant [ 10 ]. However, Athwal et al showed that screw tip design has an influence on the fixation performance [ 11 ], and the study of the IS body slope showed that it also influenced the fixation strength [ 12 ]. The use of a permanent metal IS has some disadvantages, including graft damage, tunnel widening, imaging modalities, required implant removal surgery, and increased difficulty in revision surgeries [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…For the biomechanical test, the tunnel size is suggested to be equal to or 1 mm larger than the diameter of the screw [ 14 , 15 , 22 ]. The testing bone material for the biomechanical test can be varied, for example, polyurethane block, bone biomechanical model, or cadaver [ 5 , 11 , 23 , 24 , 25 , 26 ]. The polyurethane foam block for biomechanical testing should match the material standard (ASTM F1839).…”

Section: Introductionmentioning

confidence: 99%

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In Vitro Investigation of the Fixation Performance of a Bioabsorbable Magnesium ACL Interference Screw Compared to a Conventional Interference Screw

Siroros

Merfort

Liu

et al. 2023

Life

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An anterior cruciate ligament (ACL) reconstruction is a common treatment for patients with ACL rupture that aims to regain pre-injury knee stability and kinematics. During the ACL reconstruction, one method to fix the graft is the use of an interference screw (IS). The IS should provide initial stability and secure the graft during the healing period. In recent years, magnesium has emerged as an alternative material to permanent metal and polymer ISs. In addition, differences in designs, such as the shape of the IS, can influence the fixation performance of the IS. Therefore, in this biomechanical experiment, two different screw designs with two ligament materials were compared in an insertion and a pull-out test at a rate of 1 mm/s. The screw designs were a conventional polymer screw and a magnesium screw. Porcine tendon and nylon rope were used as ligament materials. All tests were performed in polyurethane foam blocks with 15 PCF density (Synbone AG, Switzerland). As a result, both screw designs required an insertion torque of less than 3 Nm. There was a significant difference between the porcine and nylon rope in pull-out tests for each screw design. The magnesium screw had the highest pull-out force at 412.14 ± 50.00 N for porcine tendon and 707.38 ± 21.81 N for nylon rope. There were no significant differences in tunnel widening (narrow–wide ratio) between each ligament material. The magnesium screw showed the lowest narrow–wide tunnel ratio, implying a better ability to compress the graft to the tunnel. In conclusion, a more optimized magnesium IS design resulted in better graft fixation and an improved ACL reconstruction outcome.

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Mechanical characteristics and in vitro degradation kinetics analysis of polylactic glycolic acid/β-tricalcium phosphate (PLGA/β-TCP) biocomposite interference screw

Dong

Huang

Sun

et al. 2021

Polymer Degradation and Stability

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Redesigning Metal Interference Screws Can Improve Ease of Insertion While Maintaining Fixation of Soft-Tissue Anterior Cruciate Ligament Reconstruction Grafts

Cited by 6 publications

References 27 publications

Categorize the existing clamps used for tensile test of human graft– a systematic review

Categorize the existing clamps used for tensile test of human graft– a systematic review

In Vitro Investigation of the Fixation Performance of a Bioabsorbable Magnesium ACL Interference Screw Compared to a Conventional Interference Screw

Mechanical characteristics and in vitro degradation kinetics analysis of polylactic glycolic acid/β-tricalcium phosphate (PLGA/β-TCP) biocomposite interference screw

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