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首页> 外文期刊>Arthroscopy: the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association >Correlation of interference screw insertion torque with depth of placement in the tibial tunnel using a quadrupled semitendinosus-gracilis graft in anterior cruciate ligament reconstruction.
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Correlation of interference screw insertion torque with depth of placement in the tibial tunnel using a quadrupled semitendinosus-gracilis graft in anterior cruciate ligament reconstruction.

机译：在前交叉韧带重建中使用四倍半腱肌-细骨移植物，将干涉螺钉插入扭矩与胫骨隧道中放置深度的相关性。

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PURPOSE: To evaluate the insertion torque of a soft-tissue interference screw in relation to depth of insertion into the tibial tunnel when used for fixation of a quadrupled semitendinosus-gracilis autograft in anterior cruciate ligament reconstruction. TYPE OF STUDY: Biomechanical cadaver study. METHODS: Ten quadrupled semitendinosus-gracilis grafts were harvested from fresh-frozen cadaver knees and fixed in donor proximal tibias using 10-mm bioabsorbable interference screws (Arthrex, Naples, FL). A cannulated torque screwdriver was used to measure screw insertion torque at 3 depths in the tibial tunnel: the outer cortex (distal third), the articular surface (proximal third), and between these 2 points (middle third). RESULTS: The mean insertion torques for the distal third, middle third, and proximal third were 8.7, 4.7, and 4.3 in/lb, respectively. The insertion torque was significantly higher at the outer cortex (distal third) than the middle third and proximal third (joint line of the tibial tunnel) ( P < .05). CONCLUSIONS: Our results indicate a correlation between insertion torque and depth of placement of bioabsorbable interference screws used for fixation of a semitendinosus-gracilis graft. Lower insertion torque at the articular surface, resulting in lower peak load or pullout strength, may outweigh the proposed benefits of joint-line fixation of a semitendinosus-gracilis graft used for anterior cruciate ligament reconstruction. CLINICAL RELEVANCE: Studies have suggested that anatomic proximal fixation of ACL grafts in the tibial tunnel produces stability similar to intact knees. The results of our study indicate that lower insertion torque at the articular surface results in lower peak load and pullout strength of the graft, which may outweigh the proposed benefits of joint-line fixation.
机译：目的：评估软组织干涉螺钉在前交叉韧带重建中用于固定四倍体半腱肌-骨盆自体移植时相对于胫骨隧道插入深度的插入扭矩。研究类型：生物力学尸体研究。方法：从新鲜冷冻的尸体膝盖中收获十个四倍半腱肌移植物，并使用10毫米可生物吸收的干扰螺钉（Arthrex，那不勒斯，佛罗里达州）将其固定在供体胫骨近端。使用空心扭矩起子测量胫骨隧道中3个深度处的螺钉插入扭矩：外皮层（远侧三分之一），关节面（近侧三分之一）以及这两个点之间（中三分之一）。结果：远端三分之一，中间三分之一和近端三分之一的平均插入扭矩分别为8.7、4.7和4.3 in / lb。在外皮层（远端三分之一）的插入扭矩明显高于中三分之一和近端三分之一（胫骨隧道的连接线）（P <.05）。结论：我们的结果表明插入扭矩与用于固定半腱肌-肌腱移植物的生物可吸收干涉螺钉放置深度之间的相关性。在关节表面处较低的插入扭矩会导致较低的峰值负荷或拉出强度，可能会超过用于前交叉韧带重建的半腱-小穗移植物联合行固定的建议益处。临床相关性：研究表明，ACL移植物在胫骨隧道中的解剖学近端固定产生与完整膝盖相似的稳定性。我们的研究结果表明，在关节表面处较低的插入扭矩会导致较低的峰值负荷和移植物的拔出强度，这可能会超过所提出的联合手术固定的好处。

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