[Axial load in case of press-fit fixation of the ACL graft--a fundamental study].
OBJECTIVE
The aim of this study was the determination of the axial fixation load resting on smooth press-fit dowels needed for fixation of the patellar tendon graft (BTB) in order to reach the same fixation properties compared to the interference screw on anterior cruciate ligament (ACL) plasty.


METHODS
Bovine test specimens with 27 BTB grafts fixed in tibial drill holes were used and divided in 3 groups: interference screw, and press-fit cylinder (Ø 7 mm) with 150 N and 100 N axial loads. Prior to fixation, impactation of the transplant into bone was carried out. Failure testing was done in a tensiometer at a cross-head speed of 50 mm/min. Determinations of peak load and stiffness were also made.


RESULTS
Similar peak loads and stiffness were reached on introducing a press-fit dowel (slashed circle 7 mm) with 100 N and 150 N axial load compared to interference screw fixation of the BTB graft. Peak load: 988.1 N +/- 365.1 (screw) versus 1 210.4 N +/- 292.4 (dowel 150 N) and 1 109.8 N +/- 505.4 (dowel 100 N). Stiffness: 86.4 N/mm +/- 20.5 (screw) versus 102.4 N/mm +/- 15.2 (dowel 150 N) and 77.1 N/mm +/- 11.0 (dowel 100 N). There was no significant difference.


CONCLUSIONS
When introducing a press-fit dowel (slashed circle 7 mm) with 100 N axial load into a preformed bone bed, the same fixation properties are reached as in the case of an interference screw on BTB-ACL plasty.
Mayr
H O
HO
OCM -- Klinik für Orthopädische Chirurgie München, München. hermann.mayr@ocm-muenchen.de
Beck
T
T
Hube
R
R
Jäger
A
A
von Eisenhart-Rothe
R
R
Bernstein
A
A
Plitz
W
W
Hein
W
W
D000818:Animals; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D001863:Bone Screws; D050376:Bone-Patellar Tendon-Bone Grafting / Q000295:instrumentation / Q000379:methods; D004548:Elasticity; D019544:Equipment Failure Analysis; D005592:Fracture Fixation / Q000295:instrumentation* / Q000379:methods; D050724:Fractures, Cartilage / Q000503:physiopathology / Q000601:surgery*; D013502:General Surgery; D017847:Patellar Ligament / Q000503:physiopathology / Q000637:transplantation*; D013314:Stress, Mechanical; D013552:Swine; D013718:Tensile Strength; D013977:Tibia / Q000503:physiopathology / Q000601:surgery; D016474:Weight-Bearing