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Bioabsorbable Versus Metal Screw in the Fixation of Tibial Tubercle Transfer: A Cadaveric Biomechanical Study
BACKGROUND: In tibial tubercle transfer (TTT) procedures, the osteotomized and transferred tibial tubercle is usually fixed into the host bone using metal screws. PURPOSE: To compare the strength of fixation provided by a single bioabsorbable screw versus a metal screw for TTT. STUDY DESIGN: Control...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5528201/ https://www.ncbi.nlm.nih.gov/pubmed/28812035 http://dx.doi.org/10.1177/2325967117714433 |
Sumario: | BACKGROUND: In tibial tubercle transfer (TTT) procedures, the osteotomized and transferred tibial tubercle is usually fixed into the host bone using metal screws. PURPOSE: To compare the strength of fixation provided by a single bioabsorbable screw versus a metal screw for TTT. STUDY DESIGN: Controlled laboratory study. METHODS: Twenty-two pairs of human cadaveric tibiae were used to compare the fixation strength of a single 4.5-mm bicortical bioabsorbable or metal screw for TTT. In our 2-phase biomechanical testing protocol, the specimens were first subjected to a cyclic-loading test (1500 loading cycles between 50 and 300 N at 0.5 Hz frequency), after which they were loaded to failure (single-cycle load-to-failure test). To control for possible differences in bone quality, volumetric bone mineral density was determined using peripheral quantitative computed tomography. RESULTS: No significant displacement differences were observed between the 2 groups for the cyclic-loading test. In the subsequent single-cycle load-to-failure test, the mean yield load was 566 ± 234 N in the bioabsorbable screw group and 984 ± 630 N in the metal screw group (P = .002). The failure mode of bioabsorbable screws was breakage and/or bending, and that of metal screws was bending and/or pull-out. Bone density was similar in the 2 groups. CONCLUSION: A metal screw seems to provide greater fixation strength than a biodegradable screw in the TTT of a human cadaveric knee. However, considering the maximum quadriceps pull in vivo, the strength of fixation provided by a biodegradable screw seems clinically sufficient. CLINICAL RELEVANCE: Bioabsorbable screws, particularly if used in duplicate, could provide a viable option for metal screws in TTT fixation. |
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