• Myung Ku Kim, Suk In Na, Jong Min Lee, and Ju Yong Park.
• Department of Orthopedic Surgery, College of Medicine, Inha University, Incheon, Korea.
• Yonsei Med. J. 2014 May 1; 55 (3): 760-5.

PurposeThe use of graft tissue fixation using bioabsorbable interference screws (BISs) in anterior cruciate ligament (ACL) reconstruction offers various advantages, but limited pullout strength. Therefore, additional tibial fixation is essential for aggressive rehabilitation. We hypothesized that additional graft tissue fixation using bioabsorbable suture anchors (BSA) would provide sufficient pull-out strength.Materials And MethodsTwenty four fresh frozen porcine distal femur and patellar tendon preparations were used. All specimens were divided into three groups based on additional fixation methods: A, isolated BIS; B, BIS and BSA; and C, BIS and post cortical screw. Tensile testing was carried out under an axial load. Ultimate failure load and ultimate failure load after cyclic loading were recorded.ResultsThe ultimate failure loads after load to failure testing were 166.8 N in group A, 536.4 N in group B, and 438 N in group C; meanwhile, the ultimate failure loads after load to failure testing with cyclic loading were 140 N in group A, 466.5 N in group B, and 400 N in group C. Stiffness after load to failure testing was 16.5 N/mm in group A, 33.5 N/mm in group B, and 40 N/mm in group C. An additional BSA fixation resulted in a significantly higher ultimate failure load and stiffness than isolated BIS fixation, similar to post screw fixation.ConclusionAdditional fixation using a BSA provided sufficient pullout strength for ACL reconstruction. The ultimate failure load of the BSA technique was similar to that of post cortical screws.

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