Evidence map›Paper›PMID 36322386›Full record

ArticleThe American journal of sports medicine2022

The Biomechanical Stability of Bone Staples in Cortical Fixation of Tendon Grafts for Medial Collateral Ligament Reconstruction Depends on the Implant Design.

Adrian Deichsel, Michael J Raschke, Elmar Herbst, Christian Peez, Simon Oeckenpöhler, Thorben Briese, Jens Wermers, Christoph Kittl, Johannes Glasbrenner

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The American journal of sports medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
2.2field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 10 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 1 institution in 1 country.

Adrian DeichselDepartment of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Münster, Germany.
Michael J RaschkeDepartment of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Münster, Germany.
Elmar HerbstDepartment of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Münster, Germany.
Christian PeezDepartment of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Münster, Germany.
Simon OeckenpöhlerDepartment of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Münster, Germany.
Thorben BrieseDepartment of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Münster, Germany.
Jens WermersDepartment of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Münster, Germany.ORCID 0000-0002-3448-5259
Christoph KittlDepartment of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Münster, Germany.
Johannes GlasbrennerDepartment of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Münster, Germany.
University Hospital Münster · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe promising biomechanical stability of bone staples (BSs) in cortical fixation of tendon grafts for medial collateral ligament (MCL) reconstruction has been revealed by a previous investigation. However, it is currently unknown if the biomechanical stability of cortical fixation of tendon grafts depends on the BS design. PURPOSE: To assess the biomechanical stability of cortical fixation of tendon grafts in knee surgery using 4 different BS designs. STUDY

designControlled laboratory study.

methodsCortical fixation of tendon grafts was performed in a porcine knee model at the tibial insertion area of the MCL using 4 different BS designs (n = 40): 8-mm width without spikes (n = 10), 8-mm width with spikes (n = 10), 14-mm width with spikes (n = 10), and 13 mm-wide 4-prong staples with spikes (n = 10). Specimens were mounted in a materials testing machine, and cyclic loading was applied to the tendon graft (500 cycles at 50 and 100 N, respectively), followed by load-to-failure testing. The Kruskal-Wallis test was performed for statistical analysis (

resultsIn 4 of 10 specimens with graft fixation using BSs without spikes, slippage of the tendon underneath the BS led to failure of the construct during cyclic loading to 100 N. In the other groups, no fixation failure was observed during cyclic loading. Furthermore, graft fixation using BSs without spikes was found to have significantly more elongation during cyclic loading (8.2 ± 1.9 mm) and a lower ultimate failure load (170 ± 120 N) compared with graft fixation using narrow BSs with spikes (3.4 ± 1.2 mm [

conclusionThe biomechanical stability of cortical fixation of an MCL graft was comparable between each BS design with spikes (narrow, broad, and 4-prong) in a porcine knee model, whereas BSs without spikes led to failure of the fixation construct during cyclic loading in 4 of 10 specimens and increased elongation and lower ultimate failure loads in the remainder of the group. BSs without spikes may therefore not be recommended for graft fixation. CLINICAL RELEVANCE: The use of BSs can help to avoid the conflict of converging tunnels in multiligament reconstruction surgery. An implant design with spikes yields significantly higher biomechanical stability than BSs without spikes.

Indexed as

Collateral LigamentsResearch DesignAnimalsSwinebone staplescortical fixationcyclic loadingload to failuremedial collateral ligament reconstruction

Identifiers

PMID36322386
PMCPMC9729974
OpenAlexW4307972362

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.