Biomechanical Comparison of Different Fixation Techniques for Reconstruction of Tibial Avulsion Fractures of the Anterior Cruciate Ligament

Overview

Journal Int Orthop

Specialty Orthopedics

Date 2013 Mar 5

PMID 23456017

Citations 12

Authors

Marco Ezechieli

Madeline Schafer

Christoph Becher

Antonios Dratzidis

Richard Glaab

Christian Ryf

Christof Hurschler

Max Ettinger

Affiliations

Soon will be listed here.

Abstract

Purpose: The most common fixation techniques for tibial avulsion fractures of the anterior cruciate ligament (ACL) described in the literature are screw and suture fixation. The fixation of these fractures with the TightRope® device might be an alternative. Up to now it has been commonly used in other injuries, such as acromioclavicular joint or syndesmosis ruptures. The purpose of this study was to evaluate the biomechanical properties of different fixation techniques for the reconstruction of tibial avulsion fractures.

Methods: Type III tibial avulsion fractures were simulated in 40 porcine knees. Each specimen was randomly assigned to one of four groups: (1) anterograde screw fixation, (2) suture fixation, (3) TightRope® fixation or (4) control group. The initial displacement, strength to failure and the failure mode were documented.

Results: The maximum load to failure was 1,345 ± 155.5 N for the control group, 402.5 ± 117.6 N for the TightRope® group, 367 ± 115.8 N for the suture group and 311.7 ± 120.3 N for the screw group. The maximum load to failure of the control group was significantly larger compared to all other groups. The initial dislocation was 0.28 ± 0.09 mm for the control group, 0.55 ± 0.26 mm for the TightRope® group, 0.84 ± 0.15 mm for the screw group and 1.14 ± 0.9 mm for the suture group. The initial dislocation was significantly larger for the suture group compared to the TightRope® and control groups.

Conclusions: The TightRope® fixation shows significantly lower initial displacement compared to the suture group. The TightRope® fixation might be an alternative for the repair of ACL tibial avulsion fractures that can be used arthroscopically.

Citing Articles

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Improved Biomechanical Performance of Tibial Spine Fracture Repair With Suture and Anchor Fixation in Pediatric Cadaveric Knees.

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Arthroscopic mini tunnel suture bridge for ACL tibial avulsion fractures repair.

Pu J, Zheng L, Jian C Sci Rep. 2024; 14(1):25096.

PMID: 39443625 PMC: 11499657. DOI: 10.1038/s41598-024-77121-2.

Screw placement through a higher medial portal provides better initial stability in arthroscopic ACL tibial avulsion fracture fixation: a finite element analysis.

Xiao Y, Shi C, Deng G, Ding Z, Xu J, Chen B BMC Musculoskelet Disord. 2024; 25(1):564.

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The Arthroscopic Three-Point Fixation for Anterior Cruciate Ligament Avulsion Fracture: Surgical Technique.

Chanlalit C, Mahasupachai N, Sakdapanichkul C Arthrosc Tech. 2023; 12(10):e1679-e1685.

PMID: 37942113 PMC: 10628130. DOI: 10.1016/j.eats.2023.05.016.

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