Computed Tomography Imaging of BioComposite Interference Screw After ACL Reconstruction With Bone–Patellar Tendon–Bone Graft

Background: Bioabsorbable interference screws tend to have high resorption rates after anterior cruciate ligament (ACL) reconstruction; however, no studies have examined screws composed of 30% biphasic calcium phosphate and 70% poly-d-lactide (30% BCP/70% PLDLA). Purpose: To evaluate femoral and tib...

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Veröffentlicht in:Orthopaedic journal of sports medicine 2021-05, Vol.9 (5), p.23259671211006477-23259671211006477
Hauptverfasser: Scrivens, Brian, Kluczynski, Melissa A., Fineberg, Marc S., Bisson, Leslie J.
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container_issue 5
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container_title Orthopaedic journal of sports medicine
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creator Scrivens, Brian
Kluczynski, Melissa A.
Fineberg, Marc S.
Bisson, Leslie J.
description Background: Bioabsorbable interference screws tend to have high resorption rates after anterior cruciate ligament (ACL) reconstruction; however, no studies have examined screws composed of 30% biphasic calcium phosphate and 70% poly-d-lactide (30% BCP/70% PLDLA). Purpose: To evaluate femoral and tibial tunnel widening and resorption of 30% BCP/70% PLDLA interference screws and replacement with bone at 2 to 5 years after ACL reconstruction using bone–patellar tendon–bone (BTB) autograft. Study Design: Case series; Level of evidence, 4. Methods: Included were 20 patients who had undergone ACL reconstruction using BTB autograft and were reevaluated 2 to 5 years after surgery using computed tomography scans. Tunnel measurements were obtained from computed tomography scans in the sagittal and coronal planes and were compared with known tunnel measurements based on operative reports. These images and measurements were used to assess tunnel widening, resorption of the 30% BCP/70% PLDLA screw, its replacement with bone, and possible cyst formation. Paired t tests were used to compare initial and final femoral and tibial tunnel measurements. Results: The cross-sectional area of the femoral tunnel decreased at the aperture (P = .03), middle (P = .0002), and exit (P < .0001) of the tunnel compared with the initial femoral tunnel size, and the tibial tunnel cross-sectional area decreased at the aperture (P < .0001) and exit (P = .01) of the tunnel compared with the initial tibial tunnel size. Bone formation was observed in 100% of femoral tunnels and 94.7% of tibial tunnels. Screw resorption was 100% in the femur and 94.7% in the tibia at the final follow-up. Cysts were noted around the femoral tunnel in 2 patients (5.1%). Conclusion: The 30% BCP/70% PLDLA interference screws used for ACL reconstruction using BTB autograft had high rates of resorption and replacement with bone, and there were no increases in tunnel size at 2 to 5 years postoperatively. The authors observed a low rate of cyst formation and no other adverse events stemming from the use of this specific biointerference screw, suggesting that this type of screw is a reasonable option for graft fixation with minimal unfavorable events and a reliable resorption profile.
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Purpose: To evaluate femoral and tibial tunnel widening and resorption of 30% BCP/70% PLDLA interference screws and replacement with bone at 2 to 5 years after ACL reconstruction using bone–patellar tendon–bone (BTB) autograft. Study Design: Case series; Level of evidence, 4. Methods: Included were 20 patients who had undergone ACL reconstruction using BTB autograft and were reevaluated 2 to 5 years after surgery using computed tomography scans. Tunnel measurements were obtained from computed tomography scans in the sagittal and coronal planes and were compared with known tunnel measurements based on operative reports. These images and measurements were used to assess tunnel widening, resorption of the 30% BCP/70% PLDLA screw, its replacement with bone, and possible cyst formation. Paired t tests were used to compare initial and final femoral and tibial tunnel measurements. Results: The cross-sectional area of the femoral tunnel decreased at the aperture (P = .03), middle (P = .0002), and exit (P &lt; .0001) of the tunnel compared with the initial femoral tunnel size, and the tibial tunnel cross-sectional area decreased at the aperture (P &lt; .0001) and exit (P = .01) of the tunnel compared with the initial tibial tunnel size. Bone formation was observed in 100% of femoral tunnels and 94.7% of tibial tunnels. Screw resorption was 100% in the femur and 94.7% in the tibia at the final follow-up. Cysts were noted around the femoral tunnel in 2 patients (5.1%). Conclusion: The 30% BCP/70% PLDLA interference screws used for ACL reconstruction using BTB autograft had high rates of resorption and replacement with bone, and there were no increases in tunnel size at 2 to 5 years postoperatively. The authors observed a low rate of cyst formation and no other adverse events stemming from the use of this specific biointerference screw, suggesting that this type of screw is a reasonable option for graft fixation with minimal unfavorable events and a reliable resorption profile.</description><identifier>ISSN: 2325-9671</identifier><identifier>EISSN: 2325-9671</identifier><identifier>DOI: 10.1177/23259671211006477</identifier><identifier>PMID: 33997082</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Cysts ; Knee ; Orthopedics ; Sports medicine ; Tomography</subject><ispartof>Orthopaedic journal of sports medicine, 2021-05, Vol.9 (5), p.23259671211006477-23259671211006477</ispartof><rights>The Author(s) 2021</rights><rights>The Author(s) 2021.</rights><rights>The Author(s) 2021. 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Purpose: To evaluate femoral and tibial tunnel widening and resorption of 30% BCP/70% PLDLA interference screws and replacement with bone at 2 to 5 years after ACL reconstruction using bone–patellar tendon–bone (BTB) autograft. Study Design: Case series; Level of evidence, 4. Methods: Included were 20 patients who had undergone ACL reconstruction using BTB autograft and were reevaluated 2 to 5 years after surgery using computed tomography scans. Tunnel measurements were obtained from computed tomography scans in the sagittal and coronal planes and were compared with known tunnel measurements based on operative reports. These images and measurements were used to assess tunnel widening, resorption of the 30% BCP/70% PLDLA screw, its replacement with bone, and possible cyst formation. Paired t tests were used to compare initial and final femoral and tibial tunnel measurements. 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Kluczynski, Melissa A. ; Fineberg, Marc S. ; Bisson, Leslie J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c466t-a03bfbb6061dc1cfb83ab7c05666d26728c50d00dff379c8e00ca9ad6942a7313</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Cysts</topic><topic>Knee</topic><topic>Orthopedics</topic><topic>Sports medicine</topic><topic>Tomography</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Scrivens, Brian</creatorcontrib><creatorcontrib>Kluczynski, Melissa A.</creatorcontrib><creatorcontrib>Fineberg, Marc S.</creatorcontrib><creatorcontrib>Bisson, Leslie J.</creatorcontrib><collection>Sage Journals GOLD Open Access 2024</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing &amp; Allied Health Database</collection><collection>Health &amp; Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Nursing &amp; Allied Health Database (Alumni Edition)</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Orthopaedic journal of sports medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Scrivens, Brian</au><au>Kluczynski, Melissa A.</au><au>Fineberg, Marc S.</au><au>Bisson, Leslie J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Computed Tomography Imaging of BioComposite Interference Screw After ACL Reconstruction With Bone–Patellar Tendon–Bone Graft</atitle><jtitle>Orthopaedic journal of sports medicine</jtitle><addtitle>Orthop J Sports Med</addtitle><date>2021-05-01</date><risdate>2021</risdate><volume>9</volume><issue>5</issue><spage>23259671211006477</spage><epage>23259671211006477</epage><pages>23259671211006477-23259671211006477</pages><issn>2325-9671</issn><eissn>2325-9671</eissn><abstract>Background: Bioabsorbable interference screws tend to have high resorption rates after anterior cruciate ligament (ACL) reconstruction; however, no studies have examined screws composed of 30% biphasic calcium phosphate and 70% poly-d-lactide (30% BCP/70% PLDLA). Purpose: To evaluate femoral and tibial tunnel widening and resorption of 30% BCP/70% PLDLA interference screws and replacement with bone at 2 to 5 years after ACL reconstruction using bone–patellar tendon–bone (BTB) autograft. Study Design: Case series; Level of evidence, 4. Methods: Included were 20 patients who had undergone ACL reconstruction using BTB autograft and were reevaluated 2 to 5 years after surgery using computed tomography scans. Tunnel measurements were obtained from computed tomography scans in the sagittal and coronal planes and were compared with known tunnel measurements based on operative reports. These images and measurements were used to assess tunnel widening, resorption of the 30% BCP/70% PLDLA screw, its replacement with bone, and possible cyst formation. Paired t tests were used to compare initial and final femoral and tibial tunnel measurements. Results: The cross-sectional area of the femoral tunnel decreased at the aperture (P = .03), middle (P = .0002), and exit (P &lt; .0001) of the tunnel compared with the initial femoral tunnel size, and the tibial tunnel cross-sectional area decreased at the aperture (P &lt; .0001) and exit (P = .01) of the tunnel compared with the initial tibial tunnel size. Bone formation was observed in 100% of femoral tunnels and 94.7% of tibial tunnels. Screw resorption was 100% in the femur and 94.7% in the tibia at the final follow-up. Cysts were noted around the femoral tunnel in 2 patients (5.1%). Conclusion: The 30% BCP/70% PLDLA interference screws used for ACL reconstruction using BTB autograft had high rates of resorption and replacement with bone, and there were no increases in tunnel size at 2 to 5 years postoperatively. The authors observed a low rate of cyst formation and no other adverse events stemming from the use of this specific biointerference screw, suggesting that this type of screw is a reasonable option for graft fixation with minimal unfavorable events and a reliable resorption profile.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>33997082</pmid><doi>10.1177/23259671211006477</doi><oa>free_for_read</oa></addata></record>
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subjects Cysts
Knee
Orthopedics
Sports medicine
Tomography
title Computed Tomography Imaging of BioComposite Interference Screw After ACL Reconstruction With Bone–Patellar Tendon–Bone Graft
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