The Biomechanical Performance of Bone Block and Soft-Tissue Posterior Cruciate Ligament Graft Fixation With Interference Screw and Cross-Pin Techniques

Hong Chul Lim, Ji Hoon Bae, Joon Ho Wang, Tae Soo Bae, Cheol Woong Kim, Jin Ho Hwang, Ji Yeol Yoon

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Purpose: The purpose of this study was to evaluate the biomechanical properties of 4 different graft fixation constructs on the tibial side of the posterior cruciate ligament with reconstruction by use of an Achilles tendon graft. Methods: Biomechanical testing of 4 different fixation techniques was performed on 20 human cadaveric tibias and Achilles tendons. Cross-pin fixation with bone blocks (group A), interference screw fixation with bone blocks (group B), cross-pin fixation of soft tissue with backup fixation (group C), and interference screw fixation of soft tissue with backup fixation (group D) were tested. The tibia-graft fixation complex was cyclically loaded between 50 N and 250 N at 1 Hz for 1,000 cycles. After cycling, the amount of graft displacement was determined by measuring the change in grip-to-grip distance. The complex was then loaded to failure at 1 mm/s, and maximum failure load, stiffness, and mode of failure were determined. Results: Group C had a higher maximum failure load and stiffness than groups A and B (P < .05 and P < .001, respectively) but poor results for displacement (P < .05 and P < .05, respectively). The failure modes were bone block fracture, graft laceration, or cross-pin fracture in the cross-pin groups and graft pullout in the interference screw groups. Conclusions: Our study suggests that maximum failure load and stiffness of hybrid fixation for Achilles tendon graft are comparable to those of both single calcaneal bone plug fixation methods that we studied. However, tendon graft displacement was significantly greater regardless of fixation method when compared with bone plug fixation. Clinical Relevance: Hybrid fixation for soft-tissue graft on the tibial fixation site provides comparable biomechanical properties of bone-to-bone fixation.

Original languageEnglish
Pages (from-to)250-256
Number of pages7
JournalArthroscopy - Journal of Arthroscopic and Related Surgery
Volume25
Issue number3
DOIs
Publication statusPublished - 2009 Mar 1

Fingerprint

Posterior Cruciate Ligament
Transplants
Bone and Bones
Achilles Tendon
Tissue Fixation
Hand Strength
Tibia
Lacerations
Bone Fractures
Tendons

Keywords

  • Bioabsorbable interference screw
  • Double cross pins
  • Posterior cruciate ligament reconstruction
  • RigidFix
  • Tibial tunnel fixation

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

The Biomechanical Performance of Bone Block and Soft-Tissue Posterior Cruciate Ligament Graft Fixation With Interference Screw and Cross-Pin Techniques. / Lim, Hong Chul; Bae, Ji Hoon; Wang, Joon Ho; Bae, Tae Soo; Kim, Cheol Woong; Hwang, Jin Ho; Yoon, Ji Yeol.

In: Arthroscopy - Journal of Arthroscopic and Related Surgery, Vol. 25, No. 3, 01.03.2009, p. 250-256.

Research output: Contribution to journalArticle

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abstract = "Purpose: The purpose of this study was to evaluate the biomechanical properties of 4 different graft fixation constructs on the tibial side of the posterior cruciate ligament with reconstruction by use of an Achilles tendon graft. Methods: Biomechanical testing of 4 different fixation techniques was performed on 20 human cadaveric tibias and Achilles tendons. Cross-pin fixation with bone blocks (group A), interference screw fixation with bone blocks (group B), cross-pin fixation of soft tissue with backup fixation (group C), and interference screw fixation of soft tissue with backup fixation (group D) were tested. The tibia-graft fixation complex was cyclically loaded between 50 N and 250 N at 1 Hz for 1,000 cycles. After cycling, the amount of graft displacement was determined by measuring the change in grip-to-grip distance. The complex was then loaded to failure at 1 mm/s, and maximum failure load, stiffness, and mode of failure were determined. Results: Group C had a higher maximum failure load and stiffness than groups A and B (P < .05 and P < .001, respectively) but poor results for displacement (P < .05 and P < .05, respectively). The failure modes were bone block fracture, graft laceration, or cross-pin fracture in the cross-pin groups and graft pullout in the interference screw groups. Conclusions: Our study suggests that maximum failure load and stiffness of hybrid fixation for Achilles tendon graft are comparable to those of both single calcaneal bone plug fixation methods that we studied. However, tendon graft displacement was significantly greater regardless of fixation method when compared with bone plug fixation. Clinical Relevance: Hybrid fixation for soft-tissue graft on the tibial fixation site provides comparable biomechanical properties of bone-to-bone fixation.",
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