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Equal tension in all four strands of a semitendinosus graft with a low profile tibial fixation device (Cobra LFD)

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

Abstract

The article introduces a novel tibia fixation device, the Cobra Ligament Fixation Device (Cobra LFD), for anterior cruciate ligament reconstruction. The Cobra LFD has a low profile and is hooked upon the cortical bone of tibia. It is useful either for primary ACL reconstruction or for ACL revision surgery, mainly for fixation of hamstring grafts. Fixation in the cortical bone is of great importance, in particular for revision cases. Besides technical aspects, we also present the 4-year follow-up of 15 cases of ACL revision surgery, where the Cobra LFD has been used for the tibia fixation.

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References

  1. Aune AK, Ekeland A, Cawley PW (1998) Interference screw fixation of hamstring vs patellar tendon grafts for anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 6:99–102

    Article  PubMed  Google Scholar 

  2. Bak K, Jörgensen U, Ekstrand J, Scavenius M (1999) Results of reconstruction of acute ruptures of the anterior cruciate ligament with an iliotibial band autograft. Knee Surg Sports Traumatol Arthrosc 7:111–117

    Article  PubMed  Google Scholar 

  3. Brown CH Jr, Steiner ME, Carson EW (1993) The use of hamstring tendons for anterior cruciate ligament reconstruction. Technique and results. Clin Sports Med 12:723–756

    PubMed  Google Scholar 

  4. Clatworthy MG, Annear P, Bulow JU, Bartlett RJ (1999) Tunnel widening in anterior cruciate ligament reconstruction: a prospective evaluation of hamstring and patella tendon grafts. Knee Surg Sports Traumatol Arthrosc 7:138–145

    Article  PubMed  Google Scholar 

  5. Ateshian GA, Colman WW, MOW VC (1994) Quantitative anatomy of the knee joint. In: Fu FH, Harner CD, Vince KG (eds) Knee surgery. Williams & Wilkins, Baltimore, MD, pp 671–672

  6. Grana WA, Egle DM, Mahnken R, Goodhart CW (1994) An analysis of autograft fixation after anterior cruciate ligament reconstruction in a rabbit model. Am J Sports Med 22:344–351

    PubMed  Google Scholar 

  7. Hamner DL, Brown CH Jr, Steiner ME, Hecker AT, Hayes WC (1999) Hamstring tendon grafts for reconstruction of the anterior cruciate ligament: biomechanical evaluation of the use of multiple strands and tensioning techniques. Rabbit model. J Bone Joint Surg Am 81:549–557

    PubMed  Google Scholar 

  8. Höher J, Livesay GA, Ma CB, Withrow JD, Fu FH, Woo SL-Y (1999) Hamstrings graft motion in the femoral bone tunnel when using titanium button/polyester tape fixation. Knee Surg Sports Traumatol Arthrosc 7:215–219

    Article  PubMed  Google Scholar 

  9. Ishibashi Y, Rudy TW, Livesay GA, Stone JD, Fu FH, Woo SL (1997) The effect of anterior cruciate ligament graft fixation site at the tibia on knee stability: evaluation using a robotic testing system. Arthroscopy 13:177–182

    PubMed  Google Scholar 

  10. Klein JP, Lintner DM, Downs D, Vavrenka K (2003) The incidence and significance of femoral tunnel widening after quadrupled hamstring anterior cruciate ligament reconstruction using femoral cross pin fixation. Arthroscopy 19:470–476

    PubMed  Google Scholar 

  11. Kousa P, Järvinen TL, Pohjonen T, Kannus P, Kotikoski M, Järvinen M (1995) Fixation strength of a biodegradable screw in anterior cruciate ligament reconstruction. J Bone Joint Surg Br 77:901–905

    PubMed  Google Scholar 

  12. Philips T, Graf BK, Vanderby R (1996) Length changes after cyclical loading of knotted sutures and tapes (abstract). Arthroscopy 12:385

    Google Scholar 

  13. Rowden NJ, Sher D, Rogers GJ, Schindhelm K (1997) Anterior cruciate ligament graft fixation. Initial comparison of patellar tendon and semitendinosus autografts in fresh cadavers. Am J Sports Med 25:472–478

    PubMed  Google Scholar 

  14. Siegel MG, Barber-Westin SD (1999) Arthroscopic-assisted outpatient anterior cruciate ligament reconstruction using the semitendinosus and gracilis tendons. Arthroscopy 14:268–277

    Google Scholar 

  15. Spencer EE, Chissell HR, Spang JT, Feagin JA Jr (1996) Behavior of sutures used in anterior cruciate ligament reconstructive surgery. Knee Surg Sports Traumatol Arthrosc 4:84–88

    Article  PubMed  Google Scholar 

  16. Stadelmeyer DM, Lowe WR, Ilahi OA, Noble PC, Kohl HW (1999) Cyclic pull-out strength of hamstrings tendon graft fixation with soft tissue interference screws. Am J Sports Med 27:778–783

    PubMed  Google Scholar 

  17. Steiner ME, Hecker AT, Brown CH Jr, Hayes WC (1994) Anterior cruciate ligament graft fixation. Comparison of hamstring and patellar tendon grafts. Am J Sports Med 22:240–246

    Google Scholar 

  18. van Rijssel EJC, Trimbos JB, Booster MH (1989) Mechanical performance of square knots and sliding knots in surgery: a comparative study. Am J Obstet Gynecol 162:93–97

    Google Scholar 

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Correspondence to B. K. O. Engström.

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Winge, S., Dunn, P. & Engström, B.K.O. Equal tension in all four strands of a semitendinosus graft with a low profile tibial fixation device (Cobra LFD). Knee Surg Sports Traumatol Arthrosc 14, 287–290 (2006). https://doi.org/10.1007/s00167-005-0709-7

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  • DOI: https://doi.org/10.1007/s00167-005-0709-7

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