MOA Blog

Mountainstate Orthopedic Associates and ACL Reconstruction

Posted by Chad Micucci, M.D.

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May 28, 2014, 2:48:00 PM

 

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., http://www.mountainstateorthopedic.com/chad-micucci-md ,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

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

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!  http://www.mountainstateorthopedic.com/sports-related-injuries

knee pain

Chad Micucci, M.D.

Written by Chad Micucci, M.D.

Dr. Micucci joined Mountainstate Orthopedic Associates, Inc. in September of 2010. He received his undergraduate degree at West Virginia University in Physical Therapy and his medical degree at the West Virginia University School of Medicine. Following medical school, he completed his residency in Orthopedic Surgery at Allegheny General Hospital in Pittsburgh, PA. Dr. Micucci completed a fellowship in Sports Medicine and Arthroscopy at Orthopedic Research of Virginia. He is a native of Follansbee, WV and has been practicing in North Central West Virginia since 2010. He is a member of the American Academy of Orthopedic Surgeons and has been certified by the American Board of Orthopedic Surgeons since 2012. Dr. Micucci received multiple awards during his training, including the American Orthopedic Association Resident Leadership Award. He continuously updates his training to reflect the most recent orthopedic treatment options and techniques for his patients. He frequently gives talks to the surrounding community on knee injuries and arthritis and their treatments. Dr. Micucci has been published in numerous orthopedic journals, include The Arthroscopy Journal. He serves as team physician for Clay Battelle and North Marion High Schools.