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Fixation strength of a novel bioabsorbable expansion bolt for patellar tendon bone graft fixation: an experimental study in calf tibial bone

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

This biomechanical study compares the initial fixation strength of a novel bioabsorbable two-shell expansion bolt (EB) with that of a well-established interference-screw technique in bone–patellar tendon–bone (BPTB) reconstruction in a calf model. Thirty tibia plateaus (age 5–6 months) were assigned to three groups: In groups I and II, trapezoidal bone plugs of BPTB grafts were fixed with bioabsorbable poly-L-lactide interference screws (8×23 mm) or titanium interference screws (8×25 mm) respectively. In group III, semicircular grafts were fixed using bioabsorbable poly-D, L-lactide expansion bolts (5.8/8.7×10×35 mm). The tensile axis was parallel to the bone tunnel, and the construction was loaded until failure applying a displacement rate of 1 mm per second. In group II the mean ultimate loads to failure (713 N±218 N) were found to be significantly higher than those of groups I (487 N±205 N) and III (510 N±133 N). Measurement of stiffness showed 45 N/mm±13.3 in group I, 58 N/mm±17.4 in group II and 46 N/mm±6.9 in group III, and did not demonstrate significant differences. We found a correlation between insertion torque and wedge insertion force and ultimate loads to failure in all groups ( r =0.53 in group I, r =0.54 in group II, and r =0.57 in group III). Cross-section planes of bone tunnel increased by 51%, 30% and 31% respectively, following insertion of screws or expansion of bolts ( p <0.05). We conclude that ACL graft fixation by means of the presented expansion bolt demonstrates a fixation strength similar to the established bioabsorbable screw fixation, and is a reasonable alternative fixation method, especially since some of the specific pitfalls of screw fixation can be avoided.

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Acknowledgements

The authors thank Arthrex Inc., Naples, FL, USA and A.M.I. GmbH, Goetzis, Austria, for providing us with the test implants. We gratefully acknowledge the help of H. Bonel M.D. and H. Hildebrandt from the Department of Diagnostic Radiology, for their valuable support with CT measurements. The paper was partially presented at the 21st Annual Meeting of the Arthroscopy Association of North America, 25–28 April 2002, Washington, DC. This work has been sponsored by funds of the University of Munich and the board of editors of the Münchner Medizinische Wochenschrift.

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  1. Department of Orthopedic Trauma Surgery, Klinikum Grosshadern, Ludwig-Maximilians-University of Munich, Marchioninistrasse15, 81366 , Munich, Germany

    Stefan Piltz, Patrick Strunk, Ludger Meyer & Guenter Lob

  2. Laboratory of Biomechanics and Experimental Orthopedics, Klinikum Grosshadern, Ludwig-Maximilians-University of Munich, Marchioninistrasse15, 81366 , Munich, Germany

    Wolfgang Plitz

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Correspondence to Stefan Piltz.

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Piltz, S., Strunk, P., Meyer, L. et al. Fixation strength of a novel bioabsorbable expansion bolt for patellar tendon bone graft fixation: an experimental study in calf tibial bone. Knee Surg Sports Traumatol Arthrosc 12, 376–383 (2004). https://doi.org/10.1007/s00167-003-0463-7

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