Journal article

Publication year: 2017

Pages: 933-939

Journal: The Knee

Volume number: 24

Issue number: 5

ISSN: 0968-0160

eISSN: 1873-5800

Open access status: Hybrid

DOI Link: https://doi.org/10.1016/j.knee.2017.07.005

Publisher: Elsevier

Abstract: 

Background: Rupture of the anterior cruciate ligament (ACL) is one of the most common injuries of the knee. Common techniques for ACL reconstruction require a graft fixation using interference screws. Nowadays, these interference screws are normally made of titanium or polymer/ceramic composites. The main challenge of application of a fixation device made entirely of bioactive ceramic is in relation to the low strength of such materials. The purpose of this study was to evaluate a novel geometry for a fixation device made of pure hydroxyapatite for ACL reconstructions that can overcome some problems of the titanium and the polymer/ceramic screws.

Methods: Finite Element Analysis was used for optimization of the stress distribution in conventional interference screw geometry. For experimental evaluation of the new fixation device, ex vivo tests were performed.

Results: The innovative screw-like fixation device is characterized by multiple threads with a large thread pitch. The novel design enabled the insertion of the screw into the bone without the application of an external torque or a screwdriver. In turn, it also allowed for the use of low-strength and high-bioactivity materials, like hydroxyapatite. Ex vivo tests showed that the novel screw can sustain pull-out forces up to 476 N, which is comparable to that of the commercially available BioComposite(TM) interference screws (Arthrex Inc., Germany), as a reference.

Conclusions: In summary, the novel screw design is a promising strategy to develop all-ceramic fixation devices for ACL reconstructions, which may eliminate some drawbacks of the current interference screws. (C) 2017 Elsevier B.V. All rights reserved.

Harvard Citation style: Schumacher, T., Tushtev, K., Wagner, U., Becker, C., Holthaus, M., Hein, S., et al. (2017) A novel, hydroxyapatite-based screw-like device for anterior cruciate ligament (ACL) reconstructions, The Knee, 24(5), pp. 933-939. https://doi.org/10.1016/j.knee.2017.07.005

APA Citation style: Schumacher, T., Tushtev, K., Wagner, U., Becker, C., Holthaus, M., Hein, S., Haack, J., Heiss, C., Engelhardt, M., El Khassawna, T., & Rezwan, K. (2017). A novel, hydroxyapatite-based screw-like device for anterior cruciate ligament (ACL) reconstructions. The Knee. 24(5), 933-939. https://doi.org/10.1016/j.knee.2017.07.005