Highlights
- •The effects of different diameter of fixators in graft fixation for anterior cruciate ligament reconstruction (ACL-R) remain unknown and require further investigation.
- •Different diameters of cross-pin (4 mm, 5 mm and 6 mm) with fixed length of 50 mm were investigated to analyse the relationship between the size of the fixators and their mechanical stabilities in graft fixations that correlates with biomechanical behaviors of bones.
- •Localised parameters such as stress and strain by means of finite element analysis are analysed under 100 N anterior tibial load.
- •A 4 mm cross-pin provided optimum fixation stability with lower stresses at fixators than the other two cross-pins with 28% difference, offered favourable biomechanical environment for osseointegration and minimize the possibility of breakage and migration of fixators.
Abstract
For anterior cruciate ligament reconstruction (ACL-R), one of the crucial aspects
of treatment is the fixator selection that could provide initial graft fixation post-operatively.
Literature on biomechanical stabilities of different sizes of fixators as femoral
graft fixation is limited. Therefore, this study aims to analyse the influence of
different diameters of cross-pins on the stability of graft fixations after ACL-R
via finite element analysis (FEA). In the methodology, three-dimensional (3D) models
of three different diameters of cross-pins were developed, of which anterior tibial
loads (ATL) were applied onto the tibia. From the findings, the cross-pin with a smaller
diameter (4 mm) provided optimum stability than larger diameter cross-pins, whereby
it demonstrated acceptable stresses at the fixators (both cross-pin and interference
screw) with a different percentage of 28%, while the stresses at the corresponding
bones were favourable for osseointegration to occur. Besides, the strains of the knee
joint with 4 mm diameter cross-pin were also superior in providing a good biomechanical
environment for bone healing, while the recorded strain values at fixators were comparable
with a larger diameter of cross-pins without being inferior in terms of deformation.
To conclude, the cross-pin with 4 mm diameter depicted the best biomechanical aspects
in graft fixation for ACL-R since it allows better assistance for the osseointegration
process and can minimise the possibility of the breakage and migration of fixators.
This study is not only useful for medical surgeons to justify their choices of pin
diameter to treat patients, but also for researchers to conduct future studies.
Graphical Abstract
Graphical Abstract
Keywords
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Article info
Publication history
Published online: May 19, 2022
Accepted:
May 17,
2022
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© 2022 Elsevier Ltd. All rights reserved.
