ArticleOrthopaedic journal of sports medicine2025
Biomechanical Comparison of a Novel PEEK Tibial Cortical Suspension Device With 6 Metallic Femoral Cortical Suspension Devices Used in Anterior Cruciate Ligament Reconstruction.
Article in Orthopaedic journal of sports medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Conventional cortical suspensory fixation devices (CSFDs) are made of metal. Most adjustable-loop CSFDs originally intended for femoral-side fixation are also used on the tibial side during "all-inside" anterior cruciate ligament (ACL) reconstruction. The T-Button-A is a novel adjustable-loop polyether ether ketone (PEEK) CSFD intended specifically for tibial-side fixation during ACL reconstruction using the "full-tunnel" technique. Purpose/Hypothesis: The purpose of this study was to compare the biomechanical characteristics of the T-Button-A with those of 6 commercially available fixed- or adjustable-loop CSFDs. It was hypothesized that the T-Button-A would be comparable with conventional metallic CSFDs intended for femoral-side fixation in terms of its biomechanical properties. Study Design: Controlled laboratory study. Methods: Ten implants each, of T-Button-A, Tightrope RT, Proloop Ultra, Procinch RT, Infinity, Infiloop, and Endobutton CL Ultra were biomechanically tested using an axial and torsion testing machine, and an incremental load-based testing protocol comprising 3500 cycles. Elongation and load to failure on cyclic and pull-to-failure loading, respectively, were recorded for each implant and compared across all devices. The consistency of implants in completing the 3500 test cycles, and demonstrating cyclic elongation <3 mm as well as load to failure >650 N, was compared across the tested devices. Results: The T-Button-A demonstrated a mean elongation of 2.09 ± 0.43 mm, which was less than that of Infinity ( Conclusion: The biomechanical performance of the T-Button-A is comparable with most fixed- and adjustable-loop metallic CSFDs and is beyond what is considered acceptable to support ACL reconstruction grafts during early postoperative rehabilitation. Clinical Relevance: The PEEK T-Button-A is a viable alternative to conventional metallic CSFDs, for tibial-side fixation during ACL reconstruction.
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