At Mountainstate Orthopedic Associates (MOA), many of our physicians are trained in Sports Medicine and can diagnose and treat the most intricate orthopedic conditions.
Sports Medicine is a sub specialty of orthopedic surgery that focuses on musculoskeletal injuries and disorders. A large portion of orthopedic Sports Medicine is focused on arthroscopic surgery including the knee, shoulder, hip, foot and ankle.
Recently, one of our physicians, Chad Micucci, M.D., who is specially trained in Sports Medicine, assisted three other physicians in conducting and publishing research on anterior cruciate ligament (ACL) reconstruction and documented their methods of construction and their results.
Below, you will find their white paper. We thought you might find this scientific research interesting and helpful. As always, we are here to help you with any questions you may have regarding Orthopedic issues.
ACL Reconstruction
The effect of interference screw diameter on fixation of soft-tissue grafts in anterior cruciate ligament reconstruction.
Micucci CJ, Frank DA, Kompel J, Muffly M, Demeo PJ, Altman GT
Author Information
- Department of Orthopedic Surgery, Allegheny General Hospital, Pittsburgh, Pennsylvania, USA. georgi.wassilew@charite.de
Abstract
PURPOSE:
The purpose of this study was to evaluate the effect that interference screw diameter has on fixation strength of a soft-tissue anterior cruciate ligament (ACL) graft.
METHODS:
We prepared 32 fresh-frozen bovine tibiae with 9-mm ACL tibial tunnels. Accompanying 9-mm soft-tissue bovine Achilles grafts were also prepared. Bioabsorbable interference screws of increasing diameter were used for tibial fixation. There were 4 groups, consisting of 8-, 9-,10-, and 11-mm screws for fixation of the 9-mm graft in the 9-mm tunnel. Tensile testing and cyclic loading from 50 to 250 N at 2 Hz for a total of 1,500 cycles were performed with a hydraulic biaxial materials testing machine. Graft slippage was measured with a video analysis technique with photo-reflective markers. At the end of the cyclic testing, the grafts were loaded to failure, and the ultimate strength was recorded.
RESULTS:
All grafts failed at the tendon-bone-screw interface. The ultimate strength (+/- SD) was greatest for the 11 -mm screw (624 +/- 133 N), with slightly decreased strength for the 10-mm (601 +/- 54 N), 9-mm (576 +/- 85 N), and 8-mm (532 +/- 185 N) screws. Graft slippage (+/- SD) was least for the 9-mm screw (2.65 +/- 2.38 mm). There were no statistically significant differences in ultimate strength and graft slippage between screws (P= .45 and P = .34, respectively).
CONCLUSIONS:
All interference screws tested provided adequate fixation strength. The results of this study show no statistical significance for ultimate strength or graft slippage with variable screw diameter.
CLINICAL RELEVANCE:
Aperture fixation with the interference screw technique provides adequate stability for soft-tissue grafts in ACL reconstruction. Although no statistical significance was found, there was a trend toward less graft-site motion when we used a screw diameter equal to tunnel size.
2010 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
PMID:
20678709
[PubMed – indexed for MEDLINE]
Orthopedic Sports Medicine Fellow
Orthopedic Research of Virginia
Team Physician, Randolph Macon College
Team Physician, J.R. Tucker High School
Mini-Fellowship with Pittsburgh Penguins with Dr. Charles Burke
Resident Physician: Orthopedic Surgery
Allegheny General Hospital
Team Physician, Avonworth High School
Team Physician, Montour High School
Physical Therapist
Summit Physical Therapy
Outpatient/Ortho/OMT
Weirton Medical Center
Inpatient/Outpatient
PROFESSIONAL/SOCIETY MEMBERSHIPS
Medical School:
American Medical Association 2000-2005
American Medical Student Association 2000-2005
WVU Surgery Interest Group 2002-2004
WVU Mentoring Program 2001-2004
Professional:
American Academy of Orthopaedic Surgeons 2004-present
Arthroscopy Association of North America 2009-present
American Orthopedic Society for Sports Medicine 2009-present
WV State Medical Society 2010-present
RESEARCH/PUBLICATIONS
Publications:
Micucci CJ, Frank DA, Altman GT et al. The Effect of Interference Screw Diameter on Fixation of Soft Tissue Grafts in Anterior Cruciate Ligament Reconstruction. Arthroscopy. 2010 Aug; 26 (8):1105-1110.
Micucci C and Schmidt C. Arthroscopic repair of ulnar-sided triangular fibrocartilage complex tears. Operative Techniques in Orthopedics. 2007 April; 17(2): 118-124
To learn more about sports related injuries and how to prevent them, visit this link!