Effect of Geometry on the Fixation Strength of Anterior Cruciate Ligament Reconstruction Using BASHTI Technique

Hadi Moeinnia; Amir Nourani; Amirhossein Borjali; Mahdi Mohseni; Narges Ghias; Hossein Korani; Mahmoud Chizari

doi:10.1055/s-0040-1716371

The Journal of Knee Surgery, Table of Contents

J Knee Surg 2022; 35(05): 539-547
DOI: 10.1055/s-0040-1716371

Original Article

Effect of Geometry on the Fixation Strength of Anterior Cruciate Ligament Reconstruction Using BASHTI Technique

Hadi Moeinnia

¹Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran

,

Amir Nourani

¹Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran

,

Amirhossein Borjali

¹Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran

,

Mahdi Mohseni

¹Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran

,

Narges Ghias

¹Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran

,

Hossein Korani

¹Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran

,

Mahmoud Chizari

²Department of Engineering and Technology, School of Engineering and Computer Sciences, University of Hertfordshire, Hatfield, Hertfordshire, United Kingdom

› Author Affiliations

Abstract

The goal of this study is to investigate the effects of tendon and cannulated drill bit diameter on the strength of the bone and site hold tendon inside (BASHTI) fixation technique for an anterior cruciate ligament (ACL) reconstruction. Bovine digital tendons and Sawbones blocks were used to mimic the ACL reconstruction. Mechanical strength of the specimens was measured using a cyclic loading continued by a single cycle pullout load until failure to simulate the real postsurgical loading conditions. Finally, failure modes of specimens and ultimate failure load were recorded. The maximum possible tendon surface strain (i.e., tendon compression [TC]) for tendon diameters of 6, 7, 8, and 9 mm were 0.73, 0.8, 0.7, and 0.65, respectively. Eighty per cent of the specimens with tendon diameter of 6 mm and 20% of specimens with tendon diameter of 7 mm failed on the torn tendon. All samples with larger tendon diameters (i.e., 8 and 9 mm) failed on the fixation slippage. The maximum fixation strength according to the most suitable core bones for 6, 7, 8, and 9 mm tendons were 148 ± 47 N (core 9.5 mm), 258 ± 66 N (core 9.5 mm), 386 ± 128 N (core 8.5 mm), and 348 ± 146 N (core 8.5 mm), respectively. The mode of tendon failure was significantly influenced by the tendon diameter. Also, an increase in TC raised the fixation strength for all tendon diameters; however, tendon over compression decreased the fixation strength for the 8 mm tendon group. Finally, an empirical equation was proposed to predict BASHTI fixation strength.

Keywords

BASHTI technique - geometrical parameters - ACL reconstruction - fixation strength - core bone

Full Text

References

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