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Dokumenttyp:
Journal Article
Autor(en):
Forkel, Philipp; Lacheta, Lucca; von Deimling, Constantin; Lang, Jan; Buchmann, Louis; Imhoff, Andreas B; Burgkart, Rainer; Willinger, Lukas
Titel:
Modified suture-bridge technique for tibial avulsion fractures of the posterior cruciate ligament: a biomechanical comparison.
Abstract:
PURPOSE: Displaced tibial posterior cruciate ligament (PCL) avulsion fractures require surgical fixation in order to provide an adequate bone healing and to avoid a loss of posterior stability. The purpose of this study was to compare the biomechanical properties of a recently established modified suture bridge technique to a well-established transtibial pullout technique. It was hypothesized that the suture bridge technique shows lower elongation and higher load to failure force compared to a transtibial pullout fixation. METHODS: Twelve fresh-frozen human cadaveric knees were biomechanically tested using an uniaxial hydrodynamic material testing system. A standardized bony avulsion fracture of the tibial PCL insertion was generated. Two different techniques were used for fixation: (A) suture bridge configuration and (B) transtibial pullout fixation. In 90° of flexion elongation, initial stiffness and failure load were determined. RESULTS: The suture-bridge technique resulted in a significant lower elongation (4.5 ± 2.1 mm) than transtibial pullout technique (12.4 ± 3.0 mm, p < 0.001). The initial stiffness at the beginning of cyclic loading was 46.9 ± 3.9 N/mm in group A und 40.8 ± 9.0 N/mm in group B (p = 0.194). Load to failure testing exhibited 286.8 ± 88.3 N in group A and 234.3 ± 96.8 N in group B (p = 0.377). CONCLUSION: The suture bridge technique provides a significant lower construct elongation during cyclic loading. But postoperative rehabilitation must respect the low construct strength of both techniques because both fixation techniques did not show a sufficient fixation strength to allow for a more aggressive rehabilitation.
Zeitschriftentitel:
Arch Orthop Trauma Surg
Jahr:
2020
Band / Volume:
140
Heft / Issue:
1
Seitenangaben Beitrag:
59-65
Volltext / DOI:
doi:10.1007/s00402-019-03278-5
PubMed:
http://view.ncbi.nlm.nih.gov/pubmed/31559489
Print-ISSN:
0936-8051
TUM Einrichtung:
Fachgebiet Sportorthopädie (Prof. Imhoff); Klinik und Poliklinik für Orthopädie und Sportorthopädie
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