Anterior Cruciate Ligament Soft Tissue Graft Fixation in the Elderly: Is There a Reason to Use Interference Screws? A Human Cadaver Study

Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association
Christoph DomnickAndre Weimann

Abstract

To analyze the ultimate failure load, yield load, stiffness, and cyclic resistance of different anterior cruciate ligament (ACL) soft tissue graft fixation techniques in osteopenic bone. In this study, 24 fresh-frozen human cadaveric tibiae (mean age 82.6 years; range 56-96; 6 male and 6 female donors) were used. Quantitative computed tomography was performed to match bone density. Looped porcine flexor tendon grafts were chosen as ACL graft substitutes for tibial graft fixation techniques (n = 8 each): (1) hybrid fixation with an interference screw and extracortical button fixation; (2) extracortical button fixation; and (3) interference screw fixation. In single cycle mode, constructs were loaded to failure to evaluate stiffness, yield load, and maximum load. In cyclic testing, 2,000 cycles (25-100 N) were applied followed by loading to failure. A 1-way analysis of variance was performed with significance set at P = .05. Hybrid fixation resulted in significantly higher yield load (283.4 ± 86.19 N; P = .0037) and maximum load (407.9 ± 102.3 N; P = .0026) than interference screw fixation (yield load 176.4 ± 26.03, max load 231.8 ± 94.06 N) in elderly bone. Yield load after extracortical button fixation (252.9 ± 41.97 N; P = .02...Continue Reading

Citations

Dec 11, 2020·Sports Health·Matthew J BestJohn H Wilckens
Jul 13, 2021·Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association·Dylan N GreifMichael G Baraga

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