The Biomechanical Stability of Bone Staples in Cortical Fixation of Tendon Grafts for Medial Collateral Ligament Reconstruction Depends on the Implant Design.

Deichsel, Adrian; Raschke, Michael Johannes; Herbst, Elmar; Peez, Christian; Oeckenpöhler, Simon; Briese, Thorben; Wermers, Jens; Kittl, Christoph; Glasbrenner, Johannes

Abstract

The use of BSs can help to avoid the conflict of converging tunnels in multiligament reconstruction surgery. An implant design with spikes yields significantly higher biomechanical stability than BSs without spikes.; The promising biomechanical stability of bone staples (BSs) in cortical fixation of tendon grafts for medial collateral ligament (MCL) reconstruction has been revealed by a previous investigation. However, it is currently unknown if the biomechanical stability of cortical fixation of tendon grafts depends on the BS design.; To assess the biomechanical stability of cortical fixation of tendon grafts in knee surgery using 4 different BS designs.; Controlled laboratory study.; < .05), and the post hoc Dunn test was performed for multiple comparisons.; < .001], respectively). No statistical differences in elongation during cyclic loading or ultimate failure load were found between 4-prong staples with spikes (5.0 ± 1.3 mm and 304 ± 85 N) and narrow or broad staples with spikes.; The biomechanical stability of cortical fixation of an MCL graft was comparable between each BS design with spikes (narrow, broad, and 4-prong) in a porcine knee model, whereas BSs without spikes led to failure of the fixation construct during cyclic loading in 4 of 10 specimens and increased elongation and lower ultimate failure loads in the remainder of the group. BSs without spikes may therefore not be recommended for graft fixation. - CLINICAL RELEVANCE - BACKGROUND - PURPOSE - STUDY DESIGN - METHODS - RESULTS - CONCLUSION