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Biomechanical Analysis of Plate Fixation Compared With Various Screw Configurations for Use in the Latarjet Procedure
BACKGROUND: The biomechanical properties of coracoid fixation with a miniplate during the Latarjet procedure have not been described. PURPOSE: To determine the biomechanical properties of miniplate fixation for the Latarjet procedure compared with various screw fixation configurations. STUDY DESIGN:...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7361494/ https://www.ncbi.nlm.nih.gov/pubmed/32704506 http://dx.doi.org/10.1177/2325967120931399 |
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author | Frank, Rachel M. Roth, Martina Wijdicks, Coen Abel Fischer, Nicole Costantini, Alberto Di Giacomo, Giovanni Romeo, Anthony A. |
author_facet | Frank, Rachel M. Roth, Martina Wijdicks, Coen Abel Fischer, Nicole Costantini, Alberto Di Giacomo, Giovanni Romeo, Anthony A. |
author_sort | Frank, Rachel M. |
collection | PubMed |
description | BACKGROUND: The biomechanical properties of coracoid fixation with a miniplate during the Latarjet procedure have not been described. PURPOSE: To determine the biomechanical properties of miniplate fixation for the Latarjet procedure compared with various screw fixation configurations. STUDY DESIGN: Controlled laboratory study. METHODS: A total of 8 groups (n = 5 specimens per group) were tested at a screw insertion angle of 0°: (1) 3.75-mm single screw, (2) 3.75-mm double screw, (3) 3.75-mm double screw with washers, (4) 3.75-mm double screw with a miniplate, (5) 4.00-mm single screw, (6) 4.00-mm double screw, (7) 4.00-mm double screw with washers, and (8) 4.00-mm double screw with a miniplate. In addition, similar to groups 1 to 3 and 5 to 7, there were 30 additional specimens (n = 5 per group) tested at a screw insertion angle of 15° (groups 9-14). To maintain specimen uniformity, rigid polyurethane foam blocks were used. Testing parameters included a preload of 214 N for 10 seconds, cyclical loading from 184 to 736 N at 1 Hz for 100 cycles, and failure loading at a rate of 15 mm/min until 10 mm of displacement or specimen failure occurred. RESULTS: All single-screw constructs and 77% of 15° screw constructs failed before the completion of cyclical loading. Across all groups, group 8 (4.00-mm double screw with miniplate) demonstrated the highest maximum failure load (P < .001). There were no differences in failure loads among specimens with single-screw fixation (groups 1, 5, 9, and 12; P > .05). All specimens in groups 9, 10, 11, 12, 13, and 14 (insertion angle of 15°) had significantly lower maximum failure loads compared with specimens in groups 2, 3, 4, 6, 7, and 8 (insertion angle of 0°) (P < .001 for all). CONCLUSION: These results indicate significantly superior failure loads with the miniplate compared with all other constructs. Across all fixation techniques and screw sizes, constructs with screws inserted at 0° performed better than constructs with screws inserted at 15°. CLINICAL RELEVANCE: The use of a miniplate for coracoid fixation during the Latarjet procedure may provide a more durable construct for the high-demand contact athlete. |
format | Online Article Text |
id | pubmed-7361494 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-73614942020-07-22 Biomechanical Analysis of Plate Fixation Compared With Various Screw Configurations for Use in the Latarjet Procedure Frank, Rachel M. Roth, Martina Wijdicks, Coen Abel Fischer, Nicole Costantini, Alberto Di Giacomo, Giovanni Romeo, Anthony A. Orthop J Sports Med Article BACKGROUND: The biomechanical properties of coracoid fixation with a miniplate during the Latarjet procedure have not been described. PURPOSE: To determine the biomechanical properties of miniplate fixation for the Latarjet procedure compared with various screw fixation configurations. STUDY DESIGN: Controlled laboratory study. METHODS: A total of 8 groups (n = 5 specimens per group) were tested at a screw insertion angle of 0°: (1) 3.75-mm single screw, (2) 3.75-mm double screw, (3) 3.75-mm double screw with washers, (4) 3.75-mm double screw with a miniplate, (5) 4.00-mm single screw, (6) 4.00-mm double screw, (7) 4.00-mm double screw with washers, and (8) 4.00-mm double screw with a miniplate. In addition, similar to groups 1 to 3 and 5 to 7, there were 30 additional specimens (n = 5 per group) tested at a screw insertion angle of 15° (groups 9-14). To maintain specimen uniformity, rigid polyurethane foam blocks were used. Testing parameters included a preload of 214 N for 10 seconds, cyclical loading from 184 to 736 N at 1 Hz for 100 cycles, and failure loading at a rate of 15 mm/min until 10 mm of displacement or specimen failure occurred. RESULTS: All single-screw constructs and 77% of 15° screw constructs failed before the completion of cyclical loading. Across all groups, group 8 (4.00-mm double screw with miniplate) demonstrated the highest maximum failure load (P < .001). There were no differences in failure loads among specimens with single-screw fixation (groups 1, 5, 9, and 12; P > .05). All specimens in groups 9, 10, 11, 12, 13, and 14 (insertion angle of 15°) had significantly lower maximum failure loads compared with specimens in groups 2, 3, 4, 6, 7, and 8 (insertion angle of 0°) (P < .001 for all). CONCLUSION: These results indicate significantly superior failure loads with the miniplate compared with all other constructs. Across all fixation techniques and screw sizes, constructs with screws inserted at 0° performed better than constructs with screws inserted at 15°. CLINICAL RELEVANCE: The use of a miniplate for coracoid fixation during the Latarjet procedure may provide a more durable construct for the high-demand contact athlete. SAGE Publications 2020-07-14 /pmc/articles/PMC7361494/ /pubmed/32704506 http://dx.doi.org/10.1177/2325967120931399 Text en © The Author(s) 2020 https://creativecommons.org/licenses/by-nc-nd/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (https://creativecommons.org/licenses/by-nc-nd/4.0/) 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 | Article Frank, Rachel M. Roth, Martina Wijdicks, Coen Abel Fischer, Nicole Costantini, Alberto Di Giacomo, Giovanni Romeo, Anthony A. Biomechanical Analysis of Plate Fixation Compared With Various Screw Configurations for Use in the Latarjet Procedure |
title | Biomechanical Analysis of Plate Fixation Compared With Various Screw Configurations for Use in the Latarjet Procedure |
title_full | Biomechanical Analysis of Plate Fixation Compared With Various Screw Configurations for Use in the Latarjet Procedure |
title_fullStr | Biomechanical Analysis of Plate Fixation Compared With Various Screw Configurations for Use in the Latarjet Procedure |
title_full_unstemmed | Biomechanical Analysis of Plate Fixation Compared With Various Screw Configurations for Use in the Latarjet Procedure |
title_short | Biomechanical Analysis of Plate Fixation Compared With Various Screw Configurations for Use in the Latarjet Procedure |
title_sort | biomechanical analysis of plate fixation compared with various screw configurations for use in the latarjet procedure |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7361494/ https://www.ncbi.nlm.nih.gov/pubmed/32704506 http://dx.doi.org/10.1177/2325967120931399 |
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