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Biomechanische Analyse der Press-fit-Fixierung von Kreuzbandtransplantaten

Biomechanical analysis of press-fit fixation of anterior cruciate ligament transplants

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Zusammenfassung

Press-fit-Fixierungen sind interessant, da diese einen zirkulären Kontakt zwischen Knochen und Transplantat ermöglichen und Fremdmaterial vermeiden. Diese Übersichtsarbeit vergleicht etablierte mit neu entwickelten Press-fit-Fixierungen aller gängigen Transplantate und vergleicht das biomechanische Verhalten mit fremdmaterialhaltigen Fixierungen wie der Interferenzschraube.

Für die Versuche wurden 168 humane Kadavertransplantate entnommen (Alter 49,2±18,5 Jahre). Fünfzehn verschiedene Fixierungen wurden miteinander verglichen. Die Konstrukte wurden zyklisch gedehnt und dann bis zum Versagen getestet. Die submaximale Versagenslast, Steifigkeit, Elongation und Versagensart wurden verglichen.

Insgesamt zeigen einige Techniken vergleichbare biomechanische Qualitäten wie Fixierungen mit Implantaten. Einige Press-fit-Fixierungen erreichen eine ähnliche Primärstabilität wie eine Transplantatverankerung mit Implantaten. Durch die gelenknahe Verpressung mit körpereigenem Material erhält das Transplantat einen engen Kontakt zum gelenknahen kortikalen Knochen.

Abstract

Press-fit fixation of anterior cruciate ligament autografts is an interesting technique because no hardware is necessary. A total of 168 cadaveric human patellar, quadriceps and hamstring tendons (average age 49.2±18.5 years) were used and 15 different fixation methods were tested. Constructs were cyclically stretched and then loaded until failure. Maximum load to failure, stiffness and elongation during failure testing and cyclical loading were compared.

Some techniques showed comparable biomechanical qualities to interference screw fixation. All investigated double bundle fixation techniques were equal in terms of maximum load to failure, stiffness and elongation. All techniques exhibited greater elongation during initial cyclical loading.

Some of the press-fit fixation techniques investigated exhibited comparable biomechanical properties and preconditioning of the constructs is critical. Press-fit fixation enhances tendon to bone contact at the entry of the bone tunnel to the joint.

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Interessenkonflikt

Die Arbeiten wurden durch die Deutsche Arthrosehilfe und die Gesellschaft für Orthopädisch-Traumatologische Sportmedizin (GOTS) unterstützt.

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Authors and Affiliations

  1. Unfallchirurgische Klinik, Medizinische Hochschule Hannover (MHH), Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland

    M. Jagodzinski, M. Ettinger, C. Haasper, S. Hankemeier & C. Krettek

  2. Rechtsmedizinisches Institut, Medizinische Hochschule Hannover (MHH), Hannover, Deutschland

    D. Breitmeier

  3. Labor für Biomechanik und Biomaterialien, Medizinische Hochschule Hannover (MHH), Hannover, Deutschland

    C. Hurschler

Authors
  1. M. Jagodzinski
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  2. M. Ettinger
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  3. C. Haasper
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  4. S. Hankemeier
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  5. D. Breitmeier
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  6. C. Hurschler
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  7. C. Krettek
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Corresponding author

Correspondence to M. Jagodzinski.

Additional information

M. Jagodzinski und C. Haasper sind Mitglieder der AG Arthroskopische Chirurgie der Deutschen Gesellschaft für Unfallchirurgie (Leiter: Prof. Dr. H. Lill).

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Jagodzinski, M., Ettinger, M., Haasper, C. et al. Biomechanische Analyse der Press-fit-Fixierung von Kreuzbandtransplantaten. Unfallchirurg 113, 532–539 (2010). https://doi.org/10.1007/s00113-010-1788-6

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  • DOI: https://doi.org/10.1007/s00113-010-1788-6

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