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.

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.

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Different Suture Fixation Techniques For Posterior Cruciate Ligament Avulsion Fractures: A Comparative Biomechanical Study In Cadaveric Knees

Different Suture Fixation Techniques For Posterior Cruciate Ligament Avulsion Fractures: A Comparative Biomechanical Study In Cadaveric Knees

Objective

Methods

Results

Conclusion

Multi-Ligament Knee Injury ePosters

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Different Suture Fixation Techniques For Posterior Cruciate Ligament Avulsion Fractures: A Comparative Biomechanical Study In Cadaveric Knees

Different Suture Fixation Techniques For Posterior Cruciate Ligament Avulsion Fractures: A Comparative Biomechanical Study In Cadaveric Knees

Objective

Methods

Results

Conclusion