2025 ISAKOS Biennial Congress ePoster
Different Suture Fixation Techniques For Posterior Cruciate Ligament Avulsion Fractures: A Comparative Biomechanical Study In Cadaveric Knees
Sorawut Thamyongkit , MD, Bangkok THAILAND
Pasit Komonsuwan, MD, Bangkok THAILAND
Nadhaporn Saengpetch, MD, Phyathai, Bangkok THAILAND
Panya Aroonjarattham, D.Eng, Salaya, Nakornpathom THAILAND
Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Bangkok, THAILAND
FDA Status Not Applicable
Summary
This study compares suture fixation techniques and screw fixation for PCL avulsion fractures in cadaveric knees, finding no significant biomechanical differences, with bone mineral density influencing fixation strength, highlighting the importance of bone quality and rehabilitation protocols.
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Abstract
Objective
To evaluate the biomechanical properties of different suture fixation techniques in comparison to traditional antegrade screw fixation for posterior cruciate ligament (PCL) avulsion fractures.
Methods
Twenty human cadaveric knees were randomly divided into four groups: Group A (antegrade screw fixation), Group B (suture fixation with 1 FiberTape and 2 tunnels), Group C (suture fixation with 2 FiberTapes and 2 tunnels), and Group D (suture fixation with 2 FiberTapes and 3 tunnels). Biomechanical testing included cyclic loading (500 cycles between 10-100 N) followed by load-to-failure tests. Measurements included elongation, stiffness, yield load, maximum load, and failure modes. Bone mineral density (BMD) was measured for all specimens.
Results
No significant differences in biomechanical properties were observed between the groups (p > 0.05). The mean elongation values were 10.6 ± 3.4 mm (Group A), 10.1 ± 2.9 mm (Group B), 13.9 ± 3.9 mm (Group C), and 21.9 ± 15.9 mm (Group D). The mean yield loads were 404.2 ± 86.4 N (Group A), 428.6 ± 197.6 N (Group B), 375.6 ± 110.9 N (Group C), and 393.5 ± 140.2 N (Group D). Fragment breakage was the predominant failure mode in Groups A and D, while suture cut-through was more common in Groups B and C. A significant positive correlation was identified between BMD and yield load (r = 0.5108, p = 0.0214).
Conclusion
Suture fixation techniques demonstrated comparable biomechanical performance to traditional screw fixation for PCL avulsion fractures. Increasing the number of suture tapes or tunnels did not improve load-to-failure resistance. These results underscore the importance of considering bone quality when evaluating fixation strength and determining postoperative rehabilitation protocols.