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Comparison between bovine bone and titanium interference screws for implant fixation in ACL reconstruction: a biomechanical study

  • Arthroscopy and Sports Medicine
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

The application of interference screws for the fixation of bone-patellar tendon-bone (BPTB) grafts is a well-established technique in anterior-cruciate ligament reconstruction. Interference screws derived from bovine compact bone are a biological alternative to metallic or biodegradable polymer interference screws.

Materials and methods

In 60 porcine specimens, the tibial part of an anterior-cruciate ligament reconstruction was performed using a BPTB graft. To secure the graft, either an 8-mm titanium interference screw or a self-made bovine interference screw (BC), or a commercial bovine compact bone screw (Tutofix®) was used. The maximum failure load was determined by means of a universal testing machine with computer interface at a testing speed of 50 mm/min. In a second test series, cyclic sub-maximal load was applied to the test specimen from 40 to 400 N with a number of 1,000 load cycles and a frequency of 1 Hz. Subsequently, the maximum failure load was determined. The stiffness of the test specimen was investigated in both test series. Each type of interference screw was tested 10 times.

Results

A secure fixation of the grafts was achieved with all interference screws. In the experiments on the maximum load to failures, the titanium screws showed significantly higher failure loads than the Tutofix® screws (P = 0.005). The stiffness of the grafts fixed with BC screws was significantly higher as compared to the fixation with Tutofix® screws (P = 0.005). After cyclic sub-maximal loading, the maximum failure load of the titanium screws was significantly higher than that of the Tutofix® screws (P = 0.033). The fixation of the BC screws showed a significantly higher failure load (P = 0.021) and stiffness (P = 0.032) than the Tutofix® screw fixation. Except for two screw head fractures and two intra-tendinous graft ruptures, the failure mode was slippage in the interface between interference screw and bone plug.

Conclusion

Interference screws derived from bovine compact bone show similar good results as the titanium interference screws. Therefore, the safety and in vivo performance of products derived from xenogenic bone should be the focus of further investigations.

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Acknowledgments

The authors wish to thank Dr. Johanna Schmitt for translating the manuscript into English.

Conflict of interest statement

There is no conflict of interest.

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Authors and Affiliations

  1. Department of Orthopaedics and Rheumatology, University Hospital Marburg, Baldingerstraße, 35043, Marburg, Germany

    Turgay Efe, Joscha Bauer, Bilal Farouk El-Zayat, Jan Schmitt & Markus Dietmar Schofer

  2. Department of Orthopaedics, Gotenstraße 1-6, 65929, Frankfurt/Main, Germany

    Silke Herdrich

  3. Esculapclinic, Nordanlage 19, 35390, Giessen, Germany

    Leo Gotzen

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  1. Turgay Efe
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Correspondence to Turgay Efe.

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Efe, T., Bauer, J., Herdrich, S. et al. Comparison between bovine bone and titanium interference screws for implant fixation in ACL reconstruction: a biomechanical study. Arch Orthop Trauma Surg 130, 993–999 (2010). https://doi.org/10.1007/s00402-010-1052-0

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  • DOI: https://doi.org/10.1007/s00402-010-1052-0

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