Tibial Fixation of Bone-Patellar Tendon-Bone Grafts in Anterior Cruciate Ligament Reconstruction: A Cadaveric Study of Bovine Bone Screw and Biodegradable Interference Screw

Abstract

Background:

The use of interference screw fixation for bone-patellar tendon-bone grafts in anterior cruciate ligament fixation is well established. No previous study has compared bovine bone screws and biodegradable interference screws or demonstrated their efficacy for requirements associated with early rehabilitation.

Hypothesis:

There is no difference in tension loss and pull-out strength between bovine bone screws and biodegradable interference screws.

Study Design:

Controlled laboratory study.

Methods:

Anterior cruciate ligament reconstructions with bone-patellar tendon-bone allografts were performed in 40 human tibiae from 20 donors. A bovine bone screw and a polylevolactide interference screw were used for tibial fixation in each pair. A cyclic testing protocol with varying magnitude and orientation of the graft loading was developed. Cyclic tests were performed at 1 Hz for 5000 cycles with a peak force of 200 N applied to the graft. Survival rate and postcyclic-test pull-out strength were compared.

Results:

Fifteen of 20 reconstructions fixed with bovine bone screws and 17 of 20 fixed with biodegradable screws reached 5000 cycles. Graft tension drop after the 5000 cycles averaged 19.7 N (±12.9) for bovine bone screws and 18.9 N (±16.3) for biodegradable screws. There were no significant differences in tension loss and pull-out strength between the 2 types of screws.

Conclusion:

Bovine bone screws are comparable to biodegradable interference screws in providing stable tibial fixation in anterior cruciate ligament reconstruction using bone-patellar tendon-bone allografts.

Clinical Relevance:

The use of bovine bone screws may be comparable to the popular biodegradable interference screws used for anterior cruciate ligament reconstruction in postsurgery rehabilitation.