A new femoral fixation device for anterior cruciate ligament reconstruction using the outside-in technique and hamstring tendon graft: A comparison between two devices in cadaveric human knee models

• Published in: The knee 2017-10, Vol.24 (5), p.925-932
• Main Authors: Chong, Suri, Kwak, Dai-Soon, Balasubramanian, Dhanasekaraprabu, Song, Young Dong, Na, Young Gon, Kim, Tae Kyun
• Format: Article
• Language: English
• Subjects: ACL reconstruction; Adult; Aged; Anterior cruciate ligament; Anterior Cruciate Ligament Reconstruction - instrumentation; Anterior Cruciate Ligament Reconstruction - methods; Biomechanical Phenomena; Biomechanics; Cadaver; Cadavers; Elongation; EndoButton Direct; Female; Femur; Femur - surgery; Hamstring Tendons - physiopathology; Hamstring Tendons - transplantation; Humans; Kinematics; Knee; Knee Joint - surgery; Ligaments; Male; Middle Aged; New fixation device; Orthopedics; Outside-in technique; Skin & tissue grafts; Statistical analysis; Suture Anchors; T-anchor; Tendons; Transplantation, Autologous; Trends
• ISSN: 0968-0160; 1873-5800
• DOI: 10.1016/j.knee.2017.06.003

Abstract Background A new device (T-anchor) was developed for ACL reconstruction and is implanted via the outside-in technique using hamstring grafts. The purpose of this study was to compare the T-anchor with the EndoButton Direct. Methods This study was conducted on 30 cadaveric knees (15 matched pairs). There were 2 groups of 15 each in the T-anchor and EndoButton Direct groups. After the harvest of grafts, fixation site profile and graft length were measured by loading the grafts onto both devices. They were then tested on a universal testing machine to assess elongation after cyclic loading, load to failure, ultimate load, and mode of failure. Results The fixation site profile was lower in the T-anchor group than in the EndoButton Direct group (2.3 ± 0.4 mm vs. 4.7 ± 1.0 mm, P < 0.001). The length of the graft-device complex of the T-anchor specimens was longer than that of the EndoButton Direct specimens (125.0 ± 8.9 mm vs. 115.0 ± 8.7 mm, P < 0.001). The mean cyclic elongation was lower for the T-anchor group when compared with the EndoButton Direct group (2.4 ± 0.6 mm vs. 3.9 ± 2.6 mm, P = 0.015). There was no statistically significant difference in ultimate load and load to failure between the T-anchor and EndoButton Direct groups. For mode of failure, the T-anchor fared better (P = 0.013) with all failures attributed to specimens. Conclusions In this cadaveric study, the new device, T-anchor, performed better than the EndoButton Direct with respect to the above-mentioned study parameters except for ultimate load and load to failure.