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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 12/2016

01-12-2016 | Experimental Study

Biomechanical comparison of fixation techniques for medial collateral ligament anatomical augmented repair

Authors: Mohamed Omar, Maximilian Petri, Antonios Dratzidis, Simon El Nehmer, Christof Hurschler, Christian Krettek, Michael Jagodzinski, Max Ettinger

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 12/2016

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Abstract

Purpose

Although the majority of medial collateral ligament (MCL) ruptures can be treated conservatively with good results, some injuries require operative treatment. Besides MCL reconstruction, anatomical augmented repair may be considered. This study was to assess biomechanical properties of different fixation techniques regarding elongation and ultimate load to failure.

Methods

MCL anatomical augmented repair was simulated by fixation of porcine superficial digital flexor tendon grafts at porcine tibiae. Ten different fixation techniques were assessed. Fixation of the tendon graft was performed using 4.0-mm cancellous screws and either (1) 13.5-mm spiked polyether ketone (PEEK) washers; (2) 14-mm spiked washers; (3) 14-mm suture washers; (4) 14-mm customized washers; (5–8) combination of washers and No. 2 polyester sutures (FiberWire©); or using (9) single or (10) double 5.5-mm titanium suture anchors with No. 2 polyethylene sutures (Ultrabraid®). Biomechanical analysis included pretensioning of the constructs at 20 N for 30 s following cyclic loading of 250 cycles between 20 and 100 N at 1 Hz for measurement of elongation. Additionally, ultimate failure load and failure mode analysis were performed.

Results

Spiked PEEK washers secured with polyester sutures (5) yielded best biomechanical properties at time zero for both, elongation during cyclic loading (2.9 ± 0.7 mm) and ultimate failure load (469.8 ± 64.3 N).

Conclusions

These results suggest that spiked PEEK washers secured with polyester sutures are the most appropriate fixation technique for MCL anatomical augmented repair, thus providing best requirements to allow early knee mobilization and prevent secondary knee laxity.
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Metadata
Title
Biomechanical comparison of fixation techniques for medial collateral ligament anatomical augmented repair
Authors
Mohamed Omar
Maximilian Petri
Antonios Dratzidis
Simon El Nehmer
Christof Hurschler
Christian Krettek
Michael Jagodzinski
Max Ettinger
Publication date
01-12-2016
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 12/2016
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-014-3326-5

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