皮质骨嵌压钉在前交叉韧带重建中的生物力学研究

Biomechanical evaluation of tendon graft fixation at the tibial site in anteriorcruciate ligament reconstruction with cortical press-fit bolt

  • 摘要: 目的 探讨月国绳肌腱移植重建前交叉韧带(ACL)胫骨端皮质骨嵌压钉的生物力学。方法 新鲜冷冻膝关节标本21具(北京市解剖学会提供),采用四股月国绳肌腱移植重建ACL,胫骨端分别用自制皮质骨嵌压钉(n=7)、可吸收界面螺钉(n=7)和Intrafix(n=7)固定,测试最大载荷、100N和400N位移、抗拉刚度、失败模式等数据并进行统计学分析。结果 以上指标在皮质骨嵌压钉组和可吸收界面螺钉组无统计学差异。皮质骨嵌压钉组的最大拔出载荷及抗拉刚度<Intrafix固定组(P<0.05),100N位移、400N位移>Intrafix固定组(P<0.05)。结论 自制皮质骨嵌压钉的最大拔出载荷、100N位移、400N位移以及抗拉刚度均与可吸收界面螺钉相近,可以满足ACL重建固定肌腱的需要。

     

    Abstract: Objective To evaluate the biomechanical strength at the tibial site in anterior cruciate ligament(ACL)reconstruction with cortical press-fit bolt. Methods ACL was reconstructed in 21 fresh frozen cadaver knees using four-stranded hamstring tendon graft.Specimens were divided into cortical press-fit bolt group(n=7),bioabsorbable interference screw group(n=7),and intrafix group(n=7).On each sample,a load-to-failure test was performed.Ultimate failure load,stiffness,displacement of 100N and 400N, and mode of failure were recorded. Results The failure load and stiffness of cortical press-fit bolt fixation were lower than those of intrafix fixation(P<0.05).Displacement of 100N and 400N of cortical press-fit bolt fixation was higher than that of intrafix fixation (P<0.05).No statistical difference was found in cortical press-fit bolt fixation and bioabsorbable interference screw fixation(P>0.05). Conclusion The biomechanical strength of tendon graft fixation at the tibial site with cortical press-fit bolt and bioabsorbable interference screw is similar,and can meet the physiological demand of tendon graft fixation in ACL reconstruction.

     

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