Bone density may affect primary stability of anterior cruciate ligament reconstruction when organic core bone plug fixation technique used
Abstract Purpose Core Bone Plug Fixation (CBPF) technique is an implant‐less methodology for ACL reconstruction. This study investigates the effect of bone density on CBPF stability to identify the bone quality that is likely to benefit from this technique. Methods Artificial blocks with 160 (Group...
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Wiley
2022-01-01
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| Series: | Journal of Experimental Orthopaedics |
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| Online Access: | https://doi.org/10.1186/s40634-021-00441-z |
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| author | Pouya Dehestani Farzam Farahmand Amirhossein Borjali Kaveh Bashti Mahmoud Chizari |
| author_facet | Pouya Dehestani Farzam Farahmand Amirhossein Borjali Kaveh Bashti Mahmoud Chizari |
| author_sort | Pouya Dehestani |
| collection | DOAJ |
| description | Abstract Purpose Core Bone Plug Fixation (CBPF) technique is an implant‐less methodology for ACL reconstruction. This study investigates the effect of bone density on CBPF stability to identify the bone quality that is likely to benefit from this technique. Methods Artificial blocks with 160 (Group 1), 240 (Group 2), and 320 (Group 3) kg/m3 densities were used to simulate human bone with diverse qualities. These groups are representative of the elderly, middle age and young people, respectively. A tunnel was made in each test sample using a cannulated drill bit which enabled harvesting the core bone plug intact. Fresh animal tendon grafts were prepared and passed through the tunnel, so the core bone was pushed in to secure the tendon. The fixation stability was tested by applying a cyclic load following by a pullout load until the failure occurred. The selected group was compared with interference screw fixation technique as a gold standard method in ACL reconstruction. Results The Group 2 stiffness and yield strength were significantly larger than Group 1. The graft slippage of Group 1 was significantly less than Group 3. The ultimate strengths were 310 N and 363 N, in Groups 2 and 3, significantly larger than that of Group 1. The ultimate strength in fixation by interference screw was 693.18 N, significantly larger than the bone plug method. Conclusions The stability of CBPF was greatly affected by bone density. This technique is more suitable for young and middle‐aged people. With further improvements, the CBPF might be an alternative ACL reconstruction technique for patients with good bone quality. Clinical relevance The CBPF technique offers an implant‐less organic ACL reconstruction technique with numerous advantages and likely would speed up the healing process by using the patient’s own bones and tissues rather than any non‐biologic fixations. |
| format | Article |
| id | doaj-art-e7ff53d8265a492f97b7e5bcd1ea177e |
| institution | OA Journals |
| issn | 2197-1153 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Experimental Orthopaedics |
| spelling | doaj-art-e7ff53d8265a492f97b7e5bcd1ea177e2025-08-20T02:24:25ZengWileyJournal of Experimental Orthopaedics2197-11532022-01-0191n/an/a10.1186/s40634-021-00441-zBone density may affect primary stability of anterior cruciate ligament reconstruction when organic core bone plug fixation technique usedPouya Dehestani0Farzam Farahmand1Amirhossein Borjali2Kaveh Bashti3Mahmoud Chizari4Department of Mechanical EngineeringSharif University of TechnologyTehranIranDepartment of Mechanical EngineeringSharif University of TechnologyTehranIranDepartment of Mechanical EngineeringSharif University of TechnologyTehranIranDepartment of OrthopedicsDivision of Knee SurgeryShariati HospitalTehran University of Medical SciencesTehranIranDepartment of Mechanical EngineeringSharif University of TechnologyTehranIranAbstract Purpose Core Bone Plug Fixation (CBPF) technique is an implant‐less methodology for ACL reconstruction. This study investigates the effect of bone density on CBPF stability to identify the bone quality that is likely to benefit from this technique. Methods Artificial blocks with 160 (Group 1), 240 (Group 2), and 320 (Group 3) kg/m3 densities were used to simulate human bone with diverse qualities. These groups are representative of the elderly, middle age and young people, respectively. A tunnel was made in each test sample using a cannulated drill bit which enabled harvesting the core bone plug intact. Fresh animal tendon grafts were prepared and passed through the tunnel, so the core bone was pushed in to secure the tendon. The fixation stability was tested by applying a cyclic load following by a pullout load until the failure occurred. The selected group was compared with interference screw fixation technique as a gold standard method in ACL reconstruction. Results The Group 2 stiffness and yield strength were significantly larger than Group 1. The graft slippage of Group 1 was significantly less than Group 3. The ultimate strengths were 310 N and 363 N, in Groups 2 and 3, significantly larger than that of Group 1. The ultimate strength in fixation by interference screw was 693.18 N, significantly larger than the bone plug method. Conclusions The stability of CBPF was greatly affected by bone density. This technique is more suitable for young and middle‐aged people. With further improvements, the CBPF might be an alternative ACL reconstruction technique for patients with good bone quality. Clinical relevance The CBPF technique offers an implant‐less organic ACL reconstruction technique with numerous advantages and likely would speed up the healing process by using the patient’s own bones and tissues rather than any non‐biologic fixations.https://doi.org/10.1186/s40634-021-00441-zCore bone plug fixationACL reconstructionBone densityImplant‐lessTensile test |
| spellingShingle | Pouya Dehestani Farzam Farahmand Amirhossein Borjali Kaveh Bashti Mahmoud Chizari Bone density may affect primary stability of anterior cruciate ligament reconstruction when organic core bone plug fixation technique used Journal of Experimental Orthopaedics Core bone plug fixation ACL reconstruction Bone density Implant‐less Tensile test |
| title | Bone density may affect primary stability of anterior cruciate ligament reconstruction when organic core bone plug fixation technique used |
| title_full | Bone density may affect primary stability of anterior cruciate ligament reconstruction when organic core bone plug fixation technique used |
| title_fullStr | Bone density may affect primary stability of anterior cruciate ligament reconstruction when organic core bone plug fixation technique used |
| title_full_unstemmed | Bone density may affect primary stability of anterior cruciate ligament reconstruction when organic core bone plug fixation technique used |
| title_short | Bone density may affect primary stability of anterior cruciate ligament reconstruction when organic core bone plug fixation technique used |
| title_sort | bone density may affect primary stability of anterior cruciate ligament reconstruction when organic core bone plug fixation technique used |
| topic | Core bone plug fixation ACL reconstruction Bone density Implant‐less Tensile test |
| url | https://doi.org/10.1186/s40634-021-00441-z |
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