Biomechanical Evaluation of Cross-Pin Versus Interference Screw Tibial Fixation Using a Soft-Tissue Graft During Transtibial Posterior Cruciate Ligament Reconstruction

Yong Seuk Lee, Joon Ho Wang, Ji Hoon Bae, Hong Chul Lim, Jung-Ho Park, Jin Hwan Ahn, Tae Soo Bae, Bee Oh Lim

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Purpose: This article reports the biomechanical demonstration of a technique for transtibial posterior cruciate ligament (PCL) reconstruction using a soft-tissue graft with cross-pin fixation in the tibia and compares this with the biomechanical properties achieved with other methods. Methods: We used 5 paired cadaveric knees and another 10 tibias. Soft-tissue grafts were randomized. The femoral side of the anterior cruciate ligament was fixed with a Bio-TransFix device (Arthrex, Naples, FL) (group I), and the tibial side of the PCL was fixed with a Bio-TransFix device (group II). In another 10 tibias, tibial fixations were performed by use of a bio-interference screw (group III). Biomechanical testing was carried out on a testing machine, and maximal failure load, stiffness, and displacement were analyzed. The lengths of the slots of the TransFix device (Arthrex) from the near cortex were measured to compare the proper length of the device. Results: Maximal mean failure loads in groups I, II, and III were 549.3 ± 55.4 N, 570.8 ± 96.9 N, and 371.3 ± 106.2 N, respectively, showing a significant difference (P = .0003). Stiffnesses were 47.52 ± 16.84 N/mm, 59.14 ± 17.09 N/mm, and 27.60 ± 16.73 N/mm, respectively, showing a significant difference (P = .01). Mean displacements were 19.99 ± 5.79 mm, 19.09 ± 8.51 mm, and 17.58 ± 7.10 mm, respectively, showing no significant difference (P = .7535). The mean lengths of the slots of the TransFix device of the femurs and tibias were similar at 20.3 ± 1.25 mm and 20.2 ± 1.32 mm, respectively, showing no significant difference (P = .8637). Conclusions: The transtibial technique by use of cross-pin tibial fixation with a Bio-TransFix device in PCL reconstruction provides stable fixation that is comparable to that achieved by use of conventional bio-interference screw fixation and femoral fixation in an anterior cruciate ligament reconstruction, an already well-established technique. Clinical Relevance: Biomechanically, tibial cross-pin fixation compares favorably with interference screw fixation and is useful when a graft is short. However, safety issues have not yet been resolved.

Original languageEnglish
Pages (from-to)989-995
Number of pages7
JournalArthroscopy - Journal of Arthroscopic and Related Surgery
Volume25
Issue number9
DOIs
Publication statusPublished - 2009 Sep 1

Fingerprint

Tibia
Transplants
Equipment and Supplies
Thigh
Posterior Cruciate Ligament
Anterior Cruciate Ligament Reconstruction
Anterior Cruciate Ligament
Femur
Posterior Cruciate Ligament Reconstruction
Knee
Safety

Keywords

  • Bio-TransFix
  • Biomechanics
  • Cross-pin fixation
  • Posterior cruciate ligament
  • Transtibial technique

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

Biomechanical Evaluation of Cross-Pin Versus Interference Screw Tibial Fixation Using a Soft-Tissue Graft During Transtibial Posterior Cruciate Ligament Reconstruction. / Lee, Yong Seuk; Wang, Joon Ho; Bae, Ji Hoon; Lim, Hong Chul; Park, Jung-Ho; Ahn, Jin Hwan; Bae, Tae Soo; Lim, Bee Oh.

In: Arthroscopy - Journal of Arthroscopic and Related Surgery, Vol. 25, No. 9, 01.09.2009, p. 989-995.

Research output: Contribution to journalArticle

@article{5e746208a8374c9eaa8686da09635bdc,
title = "Biomechanical Evaluation of Cross-Pin Versus Interference Screw Tibial Fixation Using a Soft-Tissue Graft During Transtibial Posterior Cruciate Ligament Reconstruction",
abstract = "Purpose: This article reports the biomechanical demonstration of a technique for transtibial posterior cruciate ligament (PCL) reconstruction using a soft-tissue graft with cross-pin fixation in the tibia and compares this with the biomechanical properties achieved with other methods. Methods: We used 5 paired cadaveric knees and another 10 tibias. Soft-tissue grafts were randomized. The femoral side of the anterior cruciate ligament was fixed with a Bio-TransFix device (Arthrex, Naples, FL) (group I), and the tibial side of the PCL was fixed with a Bio-TransFix device (group II). In another 10 tibias, tibial fixations were performed by use of a bio-interference screw (group III). Biomechanical testing was carried out on a testing machine, and maximal failure load, stiffness, and displacement were analyzed. The lengths of the slots of the TransFix device (Arthrex) from the near cortex were measured to compare the proper length of the device. Results: Maximal mean failure loads in groups I, II, and III were 549.3 ± 55.4 N, 570.8 ± 96.9 N, and 371.3 ± 106.2 N, respectively, showing a significant difference (P = .0003). Stiffnesses were 47.52 ± 16.84 N/mm, 59.14 ± 17.09 N/mm, and 27.60 ± 16.73 N/mm, respectively, showing a significant difference (P = .01). Mean displacements were 19.99 ± 5.79 mm, 19.09 ± 8.51 mm, and 17.58 ± 7.10 mm, respectively, showing no significant difference (P = .7535). The mean lengths of the slots of the TransFix device of the femurs and tibias were similar at 20.3 ± 1.25 mm and 20.2 ± 1.32 mm, respectively, showing no significant difference (P = .8637). Conclusions: The transtibial technique by use of cross-pin tibial fixation with a Bio-TransFix device in PCL reconstruction provides stable fixation that is comparable to that achieved by use of conventional bio-interference screw fixation and femoral fixation in an anterior cruciate ligament reconstruction, an already well-established technique. Clinical Relevance: Biomechanically, tibial cross-pin fixation compares favorably with interference screw fixation and is useful when a graft is short. However, safety issues have not yet been resolved.",
keywords = "Bio-TransFix, Biomechanics, Cross-pin fixation, Posterior cruciate ligament, Transtibial technique",
author = "Lee, {Yong Seuk} and Wang, {Joon Ho} and Bae, {Ji Hoon} and Lim, {Hong Chul} and Jung-Ho Park and Ahn, {Jin Hwan} and Bae, {Tae Soo} and Lim, {Bee Oh}",
year = "2009",
month = "9",
day = "1",
doi = "10.1016/j.arthro.2009.02.006",
language = "English",
volume = "25",
pages = "989--995",
journal = "Arthroscopy - Journal of Arthroscopic and Related Surgery",
issn = "0749-8063",
publisher = "W.B. Saunders Ltd",
number = "9",

}

TY - JOUR

T1 - Biomechanical Evaluation of Cross-Pin Versus Interference Screw Tibial Fixation Using a Soft-Tissue Graft During Transtibial Posterior Cruciate Ligament Reconstruction

AU - Lee, Yong Seuk

AU - Wang, Joon Ho

AU - Bae, Ji Hoon

AU - Lim, Hong Chul

AU - Park, Jung-Ho

AU - Ahn, Jin Hwan

AU - Bae, Tae Soo

AU - Lim, Bee Oh

PY - 2009/9/1

Y1 - 2009/9/1

N2 - Purpose: This article reports the biomechanical demonstration of a technique for transtibial posterior cruciate ligament (PCL) reconstruction using a soft-tissue graft with cross-pin fixation in the tibia and compares this with the biomechanical properties achieved with other methods. Methods: We used 5 paired cadaveric knees and another 10 tibias. Soft-tissue grafts were randomized. The femoral side of the anterior cruciate ligament was fixed with a Bio-TransFix device (Arthrex, Naples, FL) (group I), and the tibial side of the PCL was fixed with a Bio-TransFix device (group II). In another 10 tibias, tibial fixations were performed by use of a bio-interference screw (group III). Biomechanical testing was carried out on a testing machine, and maximal failure load, stiffness, and displacement were analyzed. The lengths of the slots of the TransFix device (Arthrex) from the near cortex were measured to compare the proper length of the device. Results: Maximal mean failure loads in groups I, II, and III were 549.3 ± 55.4 N, 570.8 ± 96.9 N, and 371.3 ± 106.2 N, respectively, showing a significant difference (P = .0003). Stiffnesses were 47.52 ± 16.84 N/mm, 59.14 ± 17.09 N/mm, and 27.60 ± 16.73 N/mm, respectively, showing a significant difference (P = .01). Mean displacements were 19.99 ± 5.79 mm, 19.09 ± 8.51 mm, and 17.58 ± 7.10 mm, respectively, showing no significant difference (P = .7535). The mean lengths of the slots of the TransFix device of the femurs and tibias were similar at 20.3 ± 1.25 mm and 20.2 ± 1.32 mm, respectively, showing no significant difference (P = .8637). Conclusions: The transtibial technique by use of cross-pin tibial fixation with a Bio-TransFix device in PCL reconstruction provides stable fixation that is comparable to that achieved by use of conventional bio-interference screw fixation and femoral fixation in an anterior cruciate ligament reconstruction, an already well-established technique. Clinical Relevance: Biomechanically, tibial cross-pin fixation compares favorably with interference screw fixation and is useful when a graft is short. However, safety issues have not yet been resolved.

AB - Purpose: This article reports the biomechanical demonstration of a technique for transtibial posterior cruciate ligament (PCL) reconstruction using a soft-tissue graft with cross-pin fixation in the tibia and compares this with the biomechanical properties achieved with other methods. Methods: We used 5 paired cadaveric knees and another 10 tibias. Soft-tissue grafts were randomized. The femoral side of the anterior cruciate ligament was fixed with a Bio-TransFix device (Arthrex, Naples, FL) (group I), and the tibial side of the PCL was fixed with a Bio-TransFix device (group II). In another 10 tibias, tibial fixations were performed by use of a bio-interference screw (group III). Biomechanical testing was carried out on a testing machine, and maximal failure load, stiffness, and displacement were analyzed. The lengths of the slots of the TransFix device (Arthrex) from the near cortex were measured to compare the proper length of the device. Results: Maximal mean failure loads in groups I, II, and III were 549.3 ± 55.4 N, 570.8 ± 96.9 N, and 371.3 ± 106.2 N, respectively, showing a significant difference (P = .0003). Stiffnesses were 47.52 ± 16.84 N/mm, 59.14 ± 17.09 N/mm, and 27.60 ± 16.73 N/mm, respectively, showing a significant difference (P = .01). Mean displacements were 19.99 ± 5.79 mm, 19.09 ± 8.51 mm, and 17.58 ± 7.10 mm, respectively, showing no significant difference (P = .7535). The mean lengths of the slots of the TransFix device of the femurs and tibias were similar at 20.3 ± 1.25 mm and 20.2 ± 1.32 mm, respectively, showing no significant difference (P = .8637). Conclusions: The transtibial technique by use of cross-pin tibial fixation with a Bio-TransFix device in PCL reconstruction provides stable fixation that is comparable to that achieved by use of conventional bio-interference screw fixation and femoral fixation in an anterior cruciate ligament reconstruction, an already well-established technique. Clinical Relevance: Biomechanically, tibial cross-pin fixation compares favorably with interference screw fixation and is useful when a graft is short. However, safety issues have not yet been resolved.

KW - Bio-TransFix

KW - Biomechanics

KW - Cross-pin fixation

KW - Posterior cruciate ligament

KW - Transtibial technique

UR - http://www.scopus.com/inward/record.url?scp=69249232059&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=69249232059&partnerID=8YFLogxK

U2 - 10.1016/j.arthro.2009.02.006

DO - 10.1016/j.arthro.2009.02.006

M3 - Article

VL - 25

SP - 989

EP - 995

JO - Arthroscopy - Journal of Arthroscopic and Related Surgery

JF - Arthroscopy - Journal of Arthroscopic and Related Surgery

SN - 0749-8063

IS - 9

ER -