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Biomechanische Studie zur Fixation des Patellarsehnen- (BPTB)Transplantats mit biointegrabler CB- und Titan-Interferenzschraube

Biomechanical comparison between CB and titanium alloy interference screw for tibial bone-patellar tendon-bone graft fixation

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Arthroskopie Aims and scope

Zusammenfassung

Als Alternative zur Fixation des BPTB-Transplantats mit Interferenzschrauben aus Metall oder bioresorbierbaren Kunststoffen stehen biointegrierbare CB-Interferenzschrauben aus boviner Kompakta zur Verfügung. In einer biomechanischen Vergleichsstudie an porcinen Testpräparaten wurde die Verankerungsfestigkeit des BPTB-Transplantats im tibialen Tunnel bei Fixation mit einer 8-mm-CB- und 8-mm-Titan-Interferenzschraube unter Zugbelastung an der Tunnellängsachse evaluiert. Jeweils 10 Testpräparate/Schraubentyp wurden untersucht. Unter zyklischer, submaximaler Belastung zwischen 40 und 400 N wurde nach dem 1000. Lastzyklus weder bei der CB- noch der Titanschraubenfixation eine Blockmigration festgestellt. Im anschließenden Maximalbelastungsversuch betrug die mittlere maximale Versagenslast der CB-Schraubenfixation 887±209 N und der Titanschraubenfixation 844±229 N. Aus den Ergebnissen ist abzuleiten, dass CB-Interferenzschrauben nicht nur eine komplett biologische, sondern auch leistungsfähige biomechanische Alternative zu Metall- und bioresorbierbaren Schrauben darstellen.

Abstract

The bone-patellar tendon-bone graft (BPTB) is commonly secured in the femoral and tibial tunnel via a metal or bioabsorbable interference screw. The novel CB interference screw is derived from bovine compact bone and is biointegratable. The biomechanical properties of the PT graft fixed with the CB screw are comparable or even superior to the PT graft fixation with a titanium interference screw.

A 10 mm-wide BPTB graft and the proximal tibia were harvested from fresh porcine knee specimens. Interference screw fixation was performed for fixation of the tibial bone plug inside the tibial tunnel either using an 8-mm titanium screw or an 8-mm CB screw. On ten specimens in each group and after 1,000 cycles with 400-N load applied to the long tunnel axis the ultimate failure load was determined with a single load.

Upon completion of the cyclic submaximal loading no bone plug migration had occurred in either group. The mean maximal fixation strength in the CB screw fixation group was 887±209 N and in the titanium screw fixation group 844±229 N. CB interference screw fixation of the PT graft in the tibial tunnel of porcine specimens performed mechanically as well as titanium interference screw fixation.

The experiment suggests that the biointegratable CB interference screw fixation of the PT graft in ACL reconstruction seems to be a reasonable alternative to the metal and bioabsorbable interference screw fixation.

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  1. Klinik für Unfall-, Wiederherstellungs- und Handchirurgie , Univ.-Klinikum Gießen und Marburg GmbH, Standort Marburg, Baldingerstraße, 35033, Marburg, Deutschland

    J. Bauer,  R. Strehl & L. Gotzen

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  1. J. Bauer
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  2. R. Strehl
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  3. L. Gotzen
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Correspondence to R. Strehl.

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Bauer, J., Strehl, R. & Gotzen, L. Biomechanische Studie zur Fixation des Patellarsehnen- (BPTB)Transplantats mit biointegrabler CB- und Titan-Interferenzschraube. Arthroskopie 20, 150–153 (2007). https://doi.org/10.1007/s00142-007-0384-4

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  • DOI: https://doi.org/10.1007/s00142-007-0384-4

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