title: Mechanical properties of revision ACL reconstruction.
abstract: The aim of this study is to evaluate the mechanical properties of a revision anterior cruciate ligament (ACL) reconstruction after redrilling the original tibial bone tunnel through a retained composite screw compared with initial soft tissue graft fixation. A total of 24 porcine tendons were fixed to porcine tibial tunnels with a 10 × 35 mm composite interference screw. Following the pullout test, a revision tunnel was drilled through the first interference screw and a second graft was fixed in the bone tunnel using a larger composite screw (11 × 35 mm). Following insertion of the revision screw, the graft was reloaded as described for the primary reconstruction. Load versus displacement data were recorded for each test. There were no significant differences between the primary and revision reconstruction constructs for yield load (p = 0.62), linear stiffness (p = 0.18), maximum failure load (p = 0.57), and yield displacement (p = 0.46). These results indicate that the mechanical properties of tibial fixation for ACL reconstruction with a composite screw following a revision provide similar fixation compared with initial reconstruction in this model. Revising a failed composite ACL construct by means of overdrilling and reinstrumenting may provide fixation equivalent to the initial reconstruction.
authors.affiliation: Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island.
authors.forename: Steve B
authors.initials: SB
authors.lastname: Behrens
authors.affiliation: Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island.
authors.forename: Byung J
authors.initials: BJ
authors.lastname: Lee
authors.affiliation: Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island.
authors.forename: David
authors.initials: D
authors.lastname: Paller
authors.affiliation: Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island.
authors.forename: Eve
authors.initials: E
authors.lastname: Hoffman
authors.affiliation: Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island.
authors.forename: Wendell M R
authors.initials: WM
authors.lastname: Heard
authors.affiliation: Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island.
authors.forename: Keith O
authors.initials: KO
authors.lastname: Monchik
authors.affiliation: Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island.
authors.forename: Paul D
authors.initials: PD
authors.lastname: Fadale
mesh_terms: D000818:Animals; D059549:Anterior Cruciate Ligament Reconstruction; D012086:Reoperation; D013552:Swine; D013718:Tensile Strength; D013977:Tibia / Q000601:surgery