The Knee
Volume 18, Issue 2 , Pages 83-87, March 2011

Fixation strength of the interference screw in the femoral tunnel: The effect of screw divergence on the coronal plane

  • Tadaaki Ninomiya

      Affiliations

    • Department of Orthopaedic Surgery, Saitama Medical University, Saitama, Japan
    • Corresponding Author InformationCorresponding author. Department of Orthopaedic Surgery, Saitama Medical University, 38 Morohongo, Moroyama, Iruma-gun, Saitama, 350-0495, Japan. Tel.: +81 49 276 1238; fax: +81 49 276 1772.
    • ,
  • Yomei Tachibana

      Affiliations

    • Department of Orthopaedic Surgery, Saitama Medical University, Saitama, Japan
    • The Division of Sports Medicine, Saitama Medical University, Saitama, Japan
    • ,
  • Tsuyoshi Miyajima

      Affiliations

    • Department of Orthopaedic Surgery, Saitama Medical University, Saitama, Japan
    • ,
  • Katsuhiko Yamazaki

      Affiliations

    • Department of Orthopaedic Surgery, Saitama Medical University, Saitama, Japan
    • Department of Orthopaedic Surgery, Ogawa Red Cross Hospital, Saitama, Japan
    • ,
  • Hiromi Oda

      Affiliations

    • Department of Orthopaedic Surgery, Saitama Medical University, Saitama, Japan

Received 23 July 2009; received in revised form 3 February 2010; accepted 8 February 2010. published online 03 March 2010.

Abstract 

Clinical studies to examine the effect of screw divergence have not been applied to the fixation of hamstring grafts. A few previous reports have addressed the correlations between the loss of pullout strength and divergence on hamstring tendon fixation in biomechanical tests. The purpose of this study was to examine the effect of interference screw divergence on the coronal plane when digital flexor tendons were fixed with an interference screw.

Twenty fresh porcine hindlimb specimens were chosen. The grafts were fixed using titanium soft tissue interference screws. The hindlimbs were divided into two groups according to the insertion method of the screw. The screw was placed along the graft parallel to the long axis of the femoral tunnel in 10 specimens (parallel placement group), and the others were placed laterally at a 15° divergent angle from the bone tunnel on the coronal plane (divergence group). The cyclic-loading test was loaded for 1500cycles.

Five specimens failed because of a pull-out of the tendon in divergence group. The number of specimens that failed before the completion of cycles in the divergence group was significantly greater than that in the parallel placement group. Although the residual displacement after 1500cycles for the divergence group was greater than that for the parallel placement group, no statistically significant difference was found between the groups.

This study suggests that the screw placed laterally at a 15° divergent angle on the coronal plane decreases the fixation strength of the digital flexor tendons fixed with an interference screw.

Keywords: Interference screw fixation, Screw divergence, Anterior cruciate ligament (ACL) reconstruction

To access this article, please choose from the options below

Login to an existing account or Register a new account.

  • Purchase this article for 31.50 USD (You must login/register to purchase this article)

    Online access for 24 hours. The PDF version can be downloaded as your permanent record.

  • Subscribe to this title

    Get unlimited online access to this article and all other articles in this title 24/7 for one year.

  • Claim access now

    For current subscribers with Society Membership or Account Number.

  • Visit SciVerse ScienceDirect to see if you have access via your institution.
 

PII: S0968-0160(10)00037-2

doi:10.1016/j.knee.2010.02.003

The Knee
Volume 18, Issue 2 , Pages 83-87, March 2011

Article Tools

* Image Usage & Resolution