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First published on May 11, 2005, doi:10.1177/0363546504272265
This version was published on July 1, 2005
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The American Journal of Sports Medicine 33:1057-1064 (2005)
© 2005 American Orthopaedic Society for Sports Medicine

Biomechanical Comparison of the Bioabsorbable RetroScrew System, BioScrew XtraLok With Stress Equalization Tensioner, and 35-mm Delta Screws for Tibialis Anterior Graft–Tibial Tunnel Fixation in Porcine Tibiae

Haw Chong Chang, MBBS, FRCSEd, MMed, John Nyland, EdD, PT SCS, ATC*, Akbar Nawab, MD, Robert Burden, MS and David N. M. Caborn, MD

From the Division of Sports Medicine, Department of Orthopaedic Surgery, University of Louisville, Louisville, Kentucky

* Address correspondence to John Nyland, EdD, PT SCS, ATC, Division of Sports Medicine, Department of Orthopaedic Surgery, University of Louisville, 210 East Gray Street, Suite 1003, Louisville, KY 40202 (e-mail: john.nyland{at}louisville.edu).

Background: Achieving effective soft tissue graft–tibial tunnel fixation remains problematic.

Hypothesis: No differences would exist for tibialis anterior graft–tibial tunnel fixation when comparing the RetroScrew System (20-mm retrograde screw, 17-mm antegrade screw), the 35-mm tapered Delta Screw (manual tensioning), and the 35-mm BioScrew XtraLok (applied using an instrumented tensioner).

Study Design: Controlled laboratory study.

Methods: Porcine tibiae (apparent bone mineral density, 1.3 g/cm2) and human tendon allografts were divided into 3 matched groups of 6 specimens each before cyclic (500 cycles, 50–250 N, 1 Hz) and load-to-failure (20 mm/min) tests.

Results: The BioScrew XtraLok (210.9 ± 54.9 N/mm) and the 35-mm Delta Screw (224.3 ± 43.7 N/mm) displayed superior stiffness to the RetroScrew System (114.1 ± 23.3 N/mm) (P = .0004) during cyclic testing. The BioScrew XtraLok (1.0 ± 0.2 mm) and the Delta Screw (0.9 ± 0.2 mm) also displayed less displacement during cyclic testing than the RetroScrew System (1.8 ± 0.5 mm) (P = .001). During load-to-failure testing, the BioScrew XtraLok withstood greater loads (1436.3 ± 331.3 N) (P = .001) and displayed greater stiffness (323.6 ± 56.8 N/mm) (P = .002) than the 35-mm Delta Screw (load, 1042.2 ± 214.4 N; stiffness, 257.2 ± 22.2 N/mm) and the RetroScrew System (load, 778.7 ± 177.5 N; stiffness, 204.4 ± 52.9 N/mm).

Conclusion: The BioScrew XtraLok with instrumented tensioning displayed superior fixation to the RetroScrew System and the 35-mm Delta Screw applied with manual tensioning.

Clinical Relevance: The BioScrew XtraLok may provide superior soft tissue graft–tibial tunnel fixation. Further in vitro studies using human tissue and in vivo clinical studies are needed.

Key Words: interference screw fixation • biomechanical testing • tibialis anterior graft






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