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Strength of interference screw fixation of meniscus prosthesis matches native meniscus attachments
- Source :
- Knee Surgery, Sports Traumatology, Arthroscopy. 30:2259-2266
- Publication Year :
- 2021
- Publisher :
- Springer Science and Business Media LLC, 2021.
-
Abstract
- Purpose Meniscal surgery is one of the most common orthopaedic surgical interventions. Total meniscus replacements have been proposed as a solution for patients with irreparable meniscal injuries. Reliable fixation is crucial for the success and functionality of such implants. The aim of this study was to characterise an interference screw fixation system developed for a novel fibre-matrix-reinforced synthetic total meniscus replacement in an ovine cadaveric model. Methods Textile straps were tested in tension to failure (n = 15) and in cyclic tension (70–220 N) for 1000 cycles (n = 5). The textile strap-interference screw fixation system was tested in 4.5 mm-diameter single anterior and double posterior tunnels in North of England Mule ovine tibias aged > 2 years using titanium alloy (Ti6Al4Va) and polyether-ether-ketone (PEEK) screws (n ≥ 5). Straps were preconditioned, dynamically loaded for 1000 cycles in tension (70–220 N), the fixation slippage under cyclic loading was measured, and then pulled to failure. Results Strap stiffness was at least 12 times that recorded for human meniscal roots. Strap creep strain at the maximum load (220 N) was 0.005 following 1000 cycles. For all tunnels, pull-out failure resulted from textile strap slippage or bone fracture rather than strap rupture, which demonstrated that the textile strap was comparatively stronger than the interference screw fixation system. Pull-out load (anterior 544 ± 119 N; posterior 889 ± 157 N) was comparable to human meniscal root strength. Fixation slippage was within the acceptable range for anterior cruciate ligament graft reconstruction (anterior 1.9 ± 0.7 mm; posterior 1.9 ± 0.5 mm). Conclusion These findings show that the textile attachment-interference screw fixation system provides reliable fixation for a novel ovine meniscus implant, supporting progression to in vivo testing. This research provides a baseline for future development of novel human meniscus replacements, in relation to attachment design and fixation methods. The data suggest that surgical techniques familiar from ligament reconstruction may be used for the fixation of clinical meniscal prostheses.
- Subjects :
- medicine.medical_specialty
Anterior cruciate ligament
Meniscus replacement
1106 Human Movement and Sports Sciences
Meniscus (anatomy)
Fixation (surgical)
REGENERATION
medicine
Knee
Meniscus
Tensile
Orthopedics and Sports Medicine
CRUCIATE LIGAMENT RECONSTRUCTION
Orthodontics
FIBER-REINFORCED SCAFFOLD
OUTCOMES
Science & Technology
business.industry
Slippage
GRAFT
1103 Clinical Sciences
Bone fracture
Creep
musculoskeletal system
medicine.disease
Pull-out strength
Ovine
REPLACEMENT
Orthopedics
medicine.anatomical_structure
OSTEOARTHRITIS
Fixation system
FAILURE PROPERTIES
Orthopedic surgery
BUTTON
Ligament
Surgery
Interference screws
Implant
Cadaveric spasm
business
Life Sciences & Biomedicine
Sport Sciences
Subjects
Details
- ISSN :
- 14337347 and 09422056
- Volume :
- 30
- Database :
- OpenAIRE
- Journal :
- Knee Surgery, Sports Traumatology, Arthroscopy
- Accession number :
- edsair.doi.dedup.....cc6bd0c983d5a9c2a9df71f93eab489e