The WasherLoc and Bone Dowel: A Rigid, Slippage-Resistant Tibial Fixation Device for a Soft Tissue Anterior Cruciate Ligament Graft
نویسندگان
چکیده
The WasherLoc is a tibial fixation device for soft tissue anterior cruciate ligament (ACL) reconstruction that combines superior fixation properties (945 N strength, 507 N/mm stiffness, and high resistance to slippage) with a simple surgical technique. The WasherLoc is a washer with 13 short spikes that penetrate the soft tissue ACL graft in multiple locations and 4 long peripheral spikes that contain the graft beneath the washer. A cancellous screw is used to compress the WasherLoc against the soft tissue ACL graft and posterolateral wall of the tibial tunnel. The WasherLoc does not cause hardware symptoms because it is recessed in a counterbore drilled at the distal end of the tibial tunnel. A bone dowel harvested from the tibial tunnel is used as a joint-line fixation device in a series with the WasherLoc to improve fixation stiffness (58 N/mm) and increase the fit, which is known to enhance tendon graft-to-bone healing in the tibia. The bone dowel, which is driven to the level of the joint line anterior to the WasherLoc and soft tissue graft, prevents tunnel enlargement.
منابع مشابه
Compaction of a bone dowel in the tibial tunnel improves the fixation stiffness of a soft tissue anterior cruciate ligament graft: an in vitro study in calf tibia.
BACKGROUND Despite increasing attention on fixation of a soft tissue anterior cruciate ligament graft in the tibia, there have been no studies on the use of a bone dowel as a joint line fixation device for promoting fixation properties, especially stiffness at the time of implantation. PURPOSE To determine whether compacting a bone dowel into the tibial tunnel improves fixation stiffness, yie...
متن کاملBiomechanical Comparison Between Bashti Bone Plug Technique and Biodegradable Screw for Fixation of Grafts in Ligament surgery
Background: Ligament reconstruction is a common procedure in orthopedic surgery. Although several popular techniques are currently in use, new methods are proposed for secure fixation of the tendon graft into the bone tunnel. Purposes: We sought to introduce our new technique of Bashti bone plug for fixation of soft tissue graft in anterior cruciate ligament (ACL) reconstruction and to compar...
متن کاملStructural properties of six tibial fixation methods for anterior cruciate ligament soft tissue grafts.
This study compared the stiffness (K), yield load (YL), and slippage (SL) of six tibial fixation methods. These properties were determined from load-to-failure and cyclic tests of double-looped tendon grafts fixed to both animal and young human tissue. Tandem washers (K = 259 N/mm, YL = 1159 N, SL = 0.5 mm) and the Washerloc (K = 248 N/mm, YL = 905 N, SL = 2.0 mm) were the two best fixations. A...
متن کاملEarly tension loss in an anterior cruciate ligament graft. A cadaver study of four tibial fixation devices.
BACKGROUND The tensile force applied to an anterior cruciate ligament graft determines the maximal anterior translation; however, it is unknown whether the tensile force is transferred to the intra-articular portion of the graft and whether the intra-articular tension and maximal anterior translation are maintained shortly after ligament reconstruction. METHODS Ten cadaveric knees were recons...
متن کاملAnterior laxity, slippage, and recovery of function in the first year after tibialis allograft anterior cruciate ligament reconstruction.
BACKGROUND The increase in anterior laxity and slippage is greater with metal interference screw fixation of a hamstring anterior cruciate ligament (ACL) graft than a bone-patellar tendon-bone graft. HYPOTHESIS When slippage-resistant fixation is used with a soft tissue graft, early recovery of function does not result in a clinically important increase in anterior laxity and slippage STUDY...
متن کامل