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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...

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Autores principales: Nurmi, Janne T., Itälä, Ari, Sihvonen, Raine, Sillanpää, Petri, Kannus, Pekka, Sievänen, Harri, Järvinen, Teppo L.N.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2017
Materias:
33
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
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author Nurmi, Janne T.
Itälä, Ari
Sihvonen, Raine
Sillanpää, Petri
Kannus, Pekka
Sievänen, Harri
Järvinen, Teppo L.N.
author_facet Nurmi, Janne T.
Itälä, Ari
Sihvonen, Raine
Sillanpää, Petri
Kannus, Pekka
Sievänen, Harri
Järvinen, Teppo L.N.
author_sort Nurmi, Janne T.
collection PubMed
description 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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spelling pubmed-55282012017-08-15 Bioabsorbable Versus Metal Screw in the Fixation of Tibial Tubercle Transfer: A Cadaveric Biomechanical Study Nurmi, Janne T. Itälä, Ari Sihvonen, Raine Sillanpää, Petri Kannus, Pekka Sievänen, Harri Järvinen, Teppo L.N. Orthop J Sports Med 33 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. SAGE Publications 2017-07-10 /pmc/articles/PMC5528201/ /pubmed/28812035 http://dx.doi.org/10.1177/2325967117714433 Text en © The Author(s) 2017 http://creativecommons.org/licenses/by-nc-nd/3.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 3.0 License (http://www.creativecommons.org/licenses/by-nc-nd/3.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle 33
Nurmi, Janne T.
Itälä, Ari
Sihvonen, Raine
Sillanpää, Petri
Kannus, Pekka
Sievänen, Harri
Järvinen, Teppo L.N.
Bioabsorbable Versus Metal Screw in the Fixation of Tibial Tubercle Transfer: A Cadaveric Biomechanical Study
title Bioabsorbable Versus Metal Screw in the Fixation of Tibial Tubercle Transfer: A Cadaveric Biomechanical Study
title_full Bioabsorbable Versus Metal Screw in the Fixation of Tibial Tubercle Transfer: A Cadaveric Biomechanical Study
title_fullStr Bioabsorbable Versus Metal Screw in the Fixation of Tibial Tubercle Transfer: A Cadaveric Biomechanical Study
title_full_unstemmed Bioabsorbable Versus Metal Screw in the Fixation of Tibial Tubercle Transfer: A Cadaveric Biomechanical Study
title_short Bioabsorbable Versus Metal Screw in the Fixation of Tibial Tubercle Transfer: A Cadaveric Biomechanical Study
title_sort bioabsorbable versus metal screw in the fixation of tibial tubercle transfer: a cadaveric biomechanical study
topic 33
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5528201/
https://www.ncbi.nlm.nih.gov/pubmed/28812035
http://dx.doi.org/10.1177/2325967117714433
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