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- Title
Delta screw versus RetroScrew tibial fixation for ACL reconstruction.
- Authors
Rhee, Peter; Dahm, Diane; Stuart, Michael; Thoreson, Andrew; An, Kai-Nan; Levy, Bruce
- Abstract
Purpose: The purpose of this study is to determine whether the RetroScrew tibial fixation system offers a biomechanical advantage over the Delta screw for anterior cruciate ligament (ACL) reconstruction in cadaveric tibias with low bone mineral density (BMD). Methods: Ten matched pairs of osteoporotic cadaveric tibiae underwent simulated ACL reconstruction using quadrupled hamstring grafts with one of the two tibial fixation constructs. Group 1 was fixed with the Delta screw (DS; 35-mm antegrade biointerference screw), and group 2 was fixed with the RetroScrew system (RSS; 20-mm retrograde and 17-mm antegrade biointerference screws). Each construct was cyclically loaded (50-200 N, 1 Hz, 500 cycles) and subsequently loaded to failure (20 mm/s). Results: All specimens were osteoporotic without significant segmental (proximal, middle, and distal) BMD differences between groups by quantitative computed tomography ( P = n.s.). A trend was noted for more construct failures due to graft slippage in the DS group ( n = 3) over the RSS group ( n = 1). There were no significant differences in cyclic displacement ( P = n.s.), maximum cyclic stiffness ( P = n.s.), maximum load at failure ( P = n.s.), or pullout stiffness ( P = n.s.) between groups. Conclusions: In an osteoporotic cadaveric model, there was no significant biomechanical advantage of the RetroScrew system versus the Delta screw for tibial fixation in soft tissue graft ACL reconstruction. However, a trend toward lower graft fixation failure to cyclic loading was noted with the RetroScrew system. Level of evidence: Biomechanical comparative study, Level II.
- Subjects
ANTERIOR cruciate ligament; PLASTIC surgery; LEG; TIBIA surgery; CYCLIC loads; TOMOGRAPHY
- Publication
Knee Surgery, Sports Traumatology, Arthroscopy, 2011, Vol 19, p94
- ISSN
0942-2056
- Publication type
Article
- DOI
10.1007/s00167-011-1543-8