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Delta screw versus RetroScrew tibial fixation for ACL reconstruction

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The purpose of this study is to determine whether the RetroScrew tibial fixation system offers a biomechanical advantage over the Delta screw for anterior cruciate ligament (ACL) reconstruction in cadaveric tibias with low bone mineral density (BMD).

Methods

Ten matched pairs of osteoporotic cadaveric tibiae underwent simulated ACL reconstruction using quadrupled hamstring grafts with one of the two tibial fixation constructs. Group 1 was fixed with the Delta screw (DS; 35-mm antegrade biointerference screw), and group 2 was fixed with the RetroScrew system (RSS; 20-mm retrograde and 17-mm antegrade biointerference screws). Each construct was cyclically loaded (50–200 N, 1 Hz, 500 cycles) and subsequently loaded to failure (20 mm/s).

Results

All specimens were osteoporotic without significant segmental (proximal, middle, and distal) BMD differences between groups by quantitative computed tomography (P = n.s.). A trend was noted for more construct failures due to graft slippage in the DS group (n = 3) over the RSS group (n = 1). There were no significant differences in cyclic displacement (P = n.s.), maximum cyclic stiffness (P = n.s.), maximum load at failure (P = n.s.), or pullout stiffness (P = n.s.) between groups.

Conclusions

In an osteoporotic cadaveric model, there was no significant biomechanical advantage of the RetroScrew system versus the Delta screw for tibial fixation in soft tissue graft ACL reconstruction. However, a trend toward lower graft fixation failure to cyclic loading was noted with the RetroScrew system.

Level of evidence

Biomechanical comparative study, Level II.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Peter C. Rhee, Diane L. Dahm, Michael J. Stuart & Bruce A. Levy

  2. Biomechanics Laboratory, Mayo Clinic, Rochester, MN, USA

    Andrew Thoreson & Kai-Nan An

Authors
  1. Peter C. Rhee
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  2. Diane L. Dahm
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  3. Michael J. Stuart
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  4. Andrew Thoreson
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  5. Kai-Nan An
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  6. Bruce A. Levy
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Corresponding author

Correspondence to Bruce A. Levy.

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Rhee, P.C., Dahm, D.L., Stuart, M.J. et al. Delta screw versus RetroScrew tibial fixation for ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 19 (Suppl 1), 94–100 (2011). https://doi.org/10.1007/s00167-011-1543-8

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  • DOI: https://doi.org/10.1007/s00167-011-1543-8

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