Yavuz KOCABEY, Akbar NAWAB, John NYLAND, Erdem IŞIKAN, David CABORN

Kemik mineral yoğunluğu düşük tibialarda yumuşak doku tendon greftinin emilebilir vida-EndoPearl kombinasyonuyla tibia tüneline tespiti: Biyomekanik çalışma

Amaç: Bu biyomekanik çalışmada, yumuşak doku tendon greftinin tibia tüneline tespitinde emilebilir vida ile emilebilir vida-EndoPearl materyal kombinasyonu incelendi. Çalışma planı: On adet inek tibiası yumuşak dokularından temizlendikten sonra 7 mm çapında açılan kemik tünelleri 9 mm'ye kadar genişletildi. Tibialis anterior allogrefti, kemik mineral yoğunluğu yüksek beş tibiaya (1.36+0.4 gr/cm2) bir adet vida (10 mm çapında, 30 mm uzunluğunda) ile, kemik mineral yoğunluğu düşük beş tibiaya (0.84±0.13 gr/cm2) vida-EndoPearl kombinasyonu ile tespit edildi. Örnekler, ser-vohidrolik makinada 20 mm/dak hızla son yetmezlik yüklenmesinden önce, 10 kez 10-50 N arası, daha sonra 500 kez 50-200 N arası kuvvetle yüklenmeye maruz bırakıldı. Sonuçlar: Tekrarlayıcı yüklenme testi süresince yer değiştirme ve sertlik açısından; son yüklenme testi süresince, son yüklenme kuvveti, yer değiştirme ve sertlik açısından iki fiksasyon grubu arasında anlamlı farklılık bulunmadı (p>0.05). Çıkarımlar: İki fiksasyon grubunda tekrarlayıcı yüklenme ve son yüklenme testi süresince yerdeğiştirme ve sertlik yönünden sonuçların benzer bulunması, kemik mineral yoğunluğu düşük tibialarda vida-EndoPearl kombinasyonuyla yapılan yumuşak doku tespitlerinin greft kaymasını engelleyebileceğini göstermektedir.

Anahtar Kelimeler:

Tendonlar, Kemik vidaları, Malzeme testi, Biyomekanik, Emilebilir implantlar, Ön çapraz bağ

Soft tissue tendon graft fixation in the tibial tunnel with a bioabsorbable screw-EndoPearl combination in tibiae of low bone mineral density: A biomechanical study

Objectives: This biomechanical study evaluated soft tissue tendon graft fixation in the tibial tunnel using a bioabsorbable interference screw with or without supplemental EndoPearl device. Methods: Ten bovine tibiae were stripped of all soft tissues and bone tunnels 7 mm in diameter were drilled with dilation to 9 mm. Tibialis anterior allografts were fixed with a screw (10 mm in diameter, 30 mm in length) in five tibiae of high bone mineral density (1.36 g/cm2), and with a screw-EndoPearl combination in five tibiae of low bone mineral density (0.84 g/cm2). The specimens were cycled 10 times from 10 to 50 N, and 500 times from 50 to 200 N in a servo hydraulic test device prior to ultimate load-at-failure testing at a rate of 20 mm/min. Results: No statistically significant differences were found between the two fixation groups with respect to displacement and stiffness during cyclic testing, and with respect to load at failure, displacement, and stiffness during load-to-failure testing (p>0.05). Conclusion: The finding of similar results in both fixation groups with respect to displacement and stiffness during cyclic testing and during load-to-failure testing suggests that a screw-EndoPearl combination in tibiae of low bone mineral density may be helpful in the prevention of graft slippage.

Keywords:

Tendons, Bone Screws, Materials Testing, Biomechanics, Absorbable Implants, Anterior Cruciate Ligament,

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