Biomechanical evaluation of two methods of fixation of a flexor hallucis longus tendon graft

The Bone & Joint Journal
E BencaR Schuh

Abstract

The traditional transosseus flexor hallucis longus (FHL) tendon transfer for patients with Achilles tendinopathy requires two incisions to harvest a long tendon graft. The use of a bio-tenodesis screw enables a short graft to be used and is less invasive, but lacks supporting evidence about its biomechanical behaviour. We aimed, in this study, to compare the strength of the traditional transosseus tendon-to-tendon fixation with tendon-to-bone fixation using a tenodesis screw, in cyclical loading and ultimate load testing. Tendon grafts were undertaken in 24 paired lower-leg specimens and randomly assigned in two groups using fixation with a transosseus suture (suture group) or a tenodesis screw (screw group). The biomechanical behaviour was evaluated using cyclical and ultimate loading tests. The Student's t-test was performed to assess statistically significant differences in bone mineral density (BMD), displacement, the slope of the load-displacement curves, and load to failure. The screw group showed less displacement (loosening) during cyclical loading, which was significant during 300, 500, 600, 700, 800, 900, and 1000 cycles (p < 0.05: other cycles: 0.079 < p < 0.402). Compared with the suture group, the screw group had h...Continue Reading

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Citations

Aug 23, 2019·The Journal of Bone and Joint Surgery. American Volume·Brian SchmidtbergLauren E Geaney
May 7, 2020·International Orthopaedics·Madeleine WilleggerReinhard Schuh
May 7, 2019·Scandinavian Journal of Medicine & Science in Sports·Emir BencaReinhard Windhager
Oct 20, 2020·Bone & Joint Research·Carlotta Perucca OrfeiLaura de Girolamo
Mar 27, 2021·Foot and Ankle Surgery : Official Journal of the European Society of Foot and Ankle Surgeons·Daniel MarslandAndrew A Amis

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