Biomechanical Analysis of Single Interference Screw vs Interference Screw With Cortical Button for Flexor Hallucis Longus Transfer.

Background: Flexor hallucis longus tendon transfer (FHL) with a cortical button tension slide is an innovative addition that has not been measured against traditional methods.

Methods: 12 pairs (n=24) of fresh-frozen cadaveric tibia-to-toe samples were used and randomized to receive one of the operative FHL techniques. Specimens underwent bone density analysis.

Suture Tape-Augmented Posterior Cruciate Ligament Repair Should Be Tensioned and Fixed at Approximately 100° Knee Flexion to Prevent Loss of Full Flexion.

Purpose: To evaluate the biomechanics of simulated posterior cruciate ligament injuries (SimPCL) with and without internal brace suture tape augmentation (IBSTA) in cadaver knees.

Methods: A total of 20 cadaveric knees were used, all male, with an average age of 65 ± 18 years. Femoral tunnel isometry was evaluated at the 1/11 o'clock and 2/10 o'clock femoral positions.

The Use of Suture Augmentation for Graft Protection in ACL Reconstruction: A Biomechanical Study in Porcine Knees.

Purpose: To biomechanically evaluate the use of the suture augmentation construct at time 0 of ACL reconstruction.

Methods: Eighty porcine knees underwent ACL reconstruction using 2 techniques for graft fixation: a single suspensory construct (SSC), performed with a femoral button and tibial interference screw; and a double suspensory construct (DSC), with a femoral and tibial button. Each fixation technique was performed on 40 porcine knees divided into 4 subgroups.

Surgical Treatment of Meniscal Extrusion: A Biomechanical Study on the Role of the Medial Meniscotibial Ligaments With Early Clinical Validation.

Background: Meniscal extrusion refers to meniscal displacement out of the joint space and over the tibial margin, altering knee mechanics and increasing the risk of osteoarthritis. The meniscotibial ligaments have been shown to have an important role in meniscal stability. However, it remains unclear whether an isolated lesion of the medial meniscotibial ligaments will result in meniscal extrusion and whether repairing the detached ligament will reduce extrusion.

Biomechanical assessment of lateral ulnar collateral ligament repair and reconstruction with or without internal brace augmentation.

Background: Surgical treatment of posterolateral rotatory instability (PLRI) using primary repair or reconstruction of the lateral collateral ligament complex have proven inconsistent. This study aimed to test the hypothesis that augmentation of LUCL repair or palmaris longus tendon reconstruction using a suture tape augmentation would be associated with less rotational displacement and greater torque load to failure (LTF) compared with nonaugmented constructs.

Methods: Cadaveric elbows (n = 12 matched pairs) were used.

Reconstruction of the Medial Ulnar Collateral Ligament of the Elbow: Biomechanical Comparison of a Novel Anatomic Technique to the Docking Technique.

Background: In recent years, understanding of the anatomy of the ulnar collateral ligament (UCL) has evolved, demonstrating that the insertional footprint of the UCL on the ulna is more elongated and distally tapered than previously described. Current UCL reconstruction configurations do not typically re-create this native anatomy, which may represent a potential area for improvement.

Purpose/hypothesis: The purposes of this study were (1) to describe a novel anatomic UCL reconstruction technique designed to better replicate the native UCL anatomy and (2) to biomechanically compare this with the docking technique.

Independent Suture Tape Internal Brace Reinforcement of Bone-Patellar Tendon-Bone Allografts: Biomechanical Assessment in a Full-ACL Reconstruction Laboratory Model.

Internal bracing for anterior cruciate ligament (ACL) surgery is a relatively new concept. The purpose of this study was to evaluate the effects of an "independent" button-fixed internal brace on the biomechanical properties of ACL reconstruction in a full-construct experimental model. Three groups ( = 10 each) were tested in a full-construct porcine-bone model with human bone-patellar tendon-bone allografts using different reconstruction techniques: interference screw fixation on femur and tibia (S-S group), adjustable-loop device (ALD) fixation on the femur with tibial interference screw without suture tape (ALD-S group), and with internal brace (ALD-S-IB group).

Knotless Suture Anchor With Suture Tape Quadriceps Tendon Repair Is Biomechanically Superior to Transosseous and Traditional Suture Anchor-Based Repairs in a Cadaveric Model.

Purpose: To compare the biomechanical properties of a knotless suture anchor with suture tape quadriceps tendon repair technique with transosseous and suture anchor repair techniques.

Methods: Twenty matched pairs of cadaveric knees underwent a quadriceps tendon avulsion followed by repair via the use of transosseous tunnels with #2 high-strength sutures, 5.5-mm biocomposite fully threaded suture anchors with #2 high-strength sutures, or 4.

Biomechanical validation of load-sharing rip-stop fixation for the repair of tissue-deficient rotator cuff tears.

Background: Poor-quality tendon is one of the most difficult problems the surgeon must overcome in achieving secure fixation during rotator cuff repair. A load-sharing rip-stop construct (LSRS) has recently been proposed as a method for improving fixation strength, but the biomechanical properties of this construct have not yet been examined.

Purpose: To compare the strength of the LSRS construct to that of single-row fixation for rotator cuff repair.

Technique for creating the anterior cruciate ligament femoral socket: optimizing femoral footprint anatomic restoration using outside-in drilling.

Purpose: The purpose of this study was to investigate and optimize anterior cruciate ligament (ACL) femoral outside-in drilling technique with a goal of anatomic restoration of the footprint morphologic length, width, area, and angular orientation.

Methods: Ex vivo, computer navigation was used to create virtual 3-dimensional maps of femoral bone tunnels for ACL drill guide pin insertion paths on small, medium, and large models of averaged femora considering various pin insertion angles to the femur. We then determined which pin insertion angle resulted in an ACL femoral footprint optimally matching normal human anatomic length, width, area, and angular orientation of the footprint long axis.

A 3.5-mm-diameter anterior cruciate ligament tibial retrograde socket drilling pin is more accurate than a 2.4-mm-diameter pin.

Purpose: The purpose of this study was to evaluate the accuracy of a 3.5-mm-diameter anterior cruciate ligament (ACL) tibial retrograde socket drilling pin versus a standard, 2.4-mm drill-tipped guide pin.

Anterior cruciate ligament femoral tunnel length: cadaveric analysis comparing anteromedial portal versus outside-in technique.

Purpose: The purpose was to measure anterior cruciate ligament (ACL) femoral tunnel lengths comparing anteromedial (AM) portal and outside-in techniques.

Methods: ACL femoral guide pins were drilled into 12 cadaveric knees through the AM portal technique and then the outside-in technique in each specimen. Pin intraosseous distance was measured in millimeters by a MicroScribe 3-dimensional digitizer (Immersion, San Jose, CA).