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FEDOROVÁ, P. SRNEC, R. PĚNČÍK, J. DVOŘÁK, M. KRBEC, M. NEČAS, A.
Original Title
Intra-Articular Reinforcement of a Partially Torn Anterior Cruciate Ligament (ACL) Using Newly Developed UHMWPE Biomaterial in Combination with Hexalon ACL/PCL Screws: Ex-Vivo Mechanical Testing of an Animal Knee Model
Type
journal article in Web of Science
Language
English
Original Abstract
PURPOSE OF THE STUDY Recent trends in the experimental surgical management of a partial anterior cruciate ligament (ACL) rupture in animals show repair of an ACL lesion using novel biomaterials both for biomechanical reinforcement of a partially unstable knee and as suitable scaffolds for bone marrow stem cell therapy in a partial ACL tear. The study deals with mechanical testing of the newly developed ultra-high-molecular-weight polyethylene (UHMWPE) biomaterial anchored to bone with Hexalon biodegradable ACL/PCL screws, as a new possibility of intra-articular reinforcement of a partial ACL tear. MATERIAL AND METHODS Two groups of ex vivo pig knee models were prepared and tested as follows: the model of an ACL tear stabilised with UHMWPE biomaterial using a Hexalon ACL/PCL screw (group 1; n = 10) and the model of an ACL tear stabilised with the traditional, and in veterinary medicine used, extracapsular technique involving a monofilament nylon fibre, a clamp and a Securos bone anchor (group 2; n = 11). The models were loaded at a standing angle of 1000 and the maximum load (N) and shift (mm) values were recorded. RESULTS In group 1 the average maximal peak force was 167.6 +/- 21.7 N and the shift was on average 19.0 +/- 4.0 mm. In all 10 specimens, the maximum load made the UHMWPE implant break close to its fixation to the femur but the construct/fixation never failed at the site where the material was anchored to the bone. In group 2, the average maximal peak force was 207.3 +/- 49.2 N and the shift was on average 24.1 +/- 9.5 mm. The Securos stabilisation failed by pullout of the anchor from the femoral bone in nine out of 11 cases; the monofilament fibre ruptured in two cases. CONCLUSIONS It can be concluded that a UHMWPE substitute used in ex-vivo pig knee models has mechanical properties comparable with clinically used extracapsular Securos stabilisation and, because of its potential to carry stem cells and bioactive substances, it can meet the requirements for an implant appropriate to the unique technique of protecting a partial ACL tear. In addition, it has no critical point of ACL substitute failure at the site of its anchoring to the bone (compared to the previously used PET/PCL substitute).
Keywords
knee stabilisation; stifle surgery; ultra-high-molecular-weight polyethylene; UHMWPE; nylon monofilament thread; biodegradable screw; bone anchor
Authors
FEDOROVÁ, P.; SRNEC, R.; PĚNČÍK, J.; DVOŘÁK, M.; KRBEC, M.; NEČAS, A.
Released
1. 6. 2015
Publisher
Galén, spol. s r.o.
Location
Česká republika, Praha
ISBN
0001-5415
Periodical
Acta Chirurgie Orthopaedicae et Traumatologie Čechoslovaca
Year of study
82
Number
3
State
Czech Republic
Pages from
222
Pages to
228
Pages count
7
URL
http://www.achot.cz/detail.php?stat=752
BibTex
@article{BUT164221, author="Petra {Fedorová} and Robert {Srnec} and Jan {Pěnčík} and Milan {Dvořák} and Martin {Krbec} and Alois {Nečas}", title="Intra-Articular Reinforcement of a Partially Torn Anterior Cruciate Ligament (ACL) Using Newly Developed UHMWPE Biomaterial in Combination with Hexalon ACL/PCL Screws: Ex-Vivo Mechanical Testing of an Animal Knee Model", journal="Acta Chirurgie Orthopaedicae et Traumatologie Čechoslovaca", year="2015", volume="82", number="3", pages="222--228", issn="0001-5415", url="http://www.achot.cz/detail.php?stat=752" }