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Title of Journal: Arch Orthop Trauma Surg

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Abbravation: Archives of Orthopaedic and Trauma Surgery

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Springer Berlin Heidelberg

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DOI

10.1002/hbm.22497

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1434-3916

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ACL double bundle linked corticalaperture tibial

Authors: John Nyland Yee Han Dave Lee Mark McGinnis Shane Kibbe Yavuz Kocabey David N M Caborn
Publish Date: 2014/04/13
Volume: 134, Issue: 6, Pages: 835-842
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Abstract

The purpose of this technical note is to describe the tibial fixation characteristics for an allinside anatomic anterior cruciate ligament ACL reconstruction method that links extracortical button suspensory and aperture fixation replicating double bundle soft tissue graft function in single femoral and tibial socketsA 55° drill guide aligned guidewires in the ACL footprint center of 8 porcine tibiae mean apparent bone mineral density = 115 g/cm2 A Flipcutter created 27 mm sockets and 15 mm guidewire channels Advancement sutures seated porcine soft tissue graftPEEK implants to achieve both socket aperture and extracortical button suspensory fixation Potted specimens were loaded into a 6º of freedom clamp with the servohydraulic loading vector in direct socket alignment Constructs were preloaded to 25 N underwent 10 preconditioning cycles 0–50 N 05 Hz and 500 submaximal loading cycles 50–250 N 1 Hz prior to load to failure testing 20 mm/min Mode of failure was recorded Descriptive statistical analysis was performedAll specimens survived the biomechanical test protocol Displacement during cyclic loading was 28 ± 09 mm yield load was 4752 ± 36 N ultimate load at failure was 6714 ± 98 N stiffness was 1275 ± 15 N/mm The most common failure mode was suture pulling through the soft tissue graftThis ACL reconstruction method combines the high ultimate load to failure and low graft slippage of extracortical button suspensory fixation with the high stiffness of aperture fixation Biomechanical test findings were comparable or better to previous reports for displacement during submaximal loading ultimate failure load and construct stiffness Based on current understanding of soft tissue graft ACL reconstruction biomechanics this fixation method should enhance graftbone socket integration during healing facilitate longterm graft survival and improve patient outcomes Clinical studies are needed to confirm in vivo efficacy

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