ABSTRACT
We evaluated two newer forms of femoral fixation of hamstring grafts for anterior
cruciate ligament reconstruction, the Endobutton direct (Smith and Nephew, Andover,
MA) and Femoral intrafix (Depuy Mitek, Raynham, MA), and compare them to devices that
have been evaluated in the literature, the AXL Crosspin (Biomet, Warsaw, IN) and Biotransfix
II (Arthrex, Naples, FL). Paired hamstring tendon allografts were fixed in the femoral
tunnel of 24 cadaveric bovine knees (6 per group) according to each device's specifications.
The free ends (tibial sides) were fixed to the materials testing machine via custom-made
cryo-clamps. In Phase I, single load to failure and stiffness were evaluated, and
in Phase II, peak displacement was evaluated while cyclic loading was performed over
1000 cycles. One-way analyses of variance were performed to test for differences between
groups. There were no significant differences in failure load (p = 0.42) or stiffness (p = 0.39) between the fixation devices. There was also no significant difference in
peak displacement measured during the cyclic loading phase (p = 0.32). Our findings suggest that the newer generation devices, Endobutton direct
and Femoral intrafix, have similar strength in single load to failure and similar
peak displacement during cyclic loading as compared with clinically proven Crosspin
techniques. These newer devices, which are designed to accommodate for more anatomic
femoral tunnel placement, may provide a reasonable alternative without compromising
biomechanical properties.
KEYWORDS
Anterior cruciate ligament - biomechanics - hamstring - graft - femur - fixation
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David C FlaniganM.D.
Sports Medicine Center, The Ohio State University
2050 Kenny Road, Suite 3300, Columbus, OH 43221
Email: flaniganOSUortho@gmail.com
