Initial fixation strength of bioabsorbable and titanium interference screws in anterior cruciate ligament reconstruction. Biomechanical evaluation by single cycle and cyclic loading

• Published in: The American journal of sports medicine Vol. 29; no. 4; p. 420
• Main Authors: Kousa, P, Järvinen, T L, Kannus, P, Järvinen, M
• Format: Journal Article
• Language: English
• Published: United States 01.07.2001
• Subjects: Absorbable Implants; Animals; Anterior Cruciate Ligament - surgery; Anterior Cruciate Ligament - transplantation; Biomechanical Phenomena; Bone Screws; Equipment Failure Analysis; In Vitro Techniques; Materials Testing; Reconstructive Surgical Procedures - instrumentation; Swine; Tensile Strength; Tibia - surgery; Titanium; Weight-Bearing
• ISSN: 0363-5465
• DOI: 10.1177/03635465010290040601

We evaluated the initial bone-patellar tendon-bone graft fixation strength of bioabsorbable as compared with titanium interference screws in anterior cruciate ligament reconstruction using matched pairs of porcine knees. Ten pairs underwent single-cycle failure loading at a rate of 50 mm/min, and 10 pairs underwent cyclic loading at half-hertz frequency. The cyclic loading started with 100 load cycles between 50 and 150 N. We then progressively increased loads in 50-N increments after each set of 100 cycles. After 100 cycles at 850 N, the specimens were loaded to failure at a rate of 50 mm/min. In the single-cycle failure loading test, the mean ultimate failure loads (+/-SD) for the bioabsorbable (837 +/- 260 N) and titanium interference screws (863 +/- 192 N) were not significantly different, nor were the mean yield loads or the stiffness of the fixation. In the cyclic loading test, the yield loads were 605 +/- 142 N and 585 +/- 103 N for the bioabsorbable and titanium interference screws, respectively (no significant difference). Although there was no significant difference in the ultimate failure load, more bone block fractures were found in the grafts fixed with a titanium interference screw. Bioabsorbable interference screw fixation thus seems to provide a reasonable alternative to titanium screws.