Modified application of interface screw in femoral side during anterior cruciate ligament reconstruction / 中国骨伤

OBJECTIVE@#To compare clinical effects of the improved interface screw fixation of femoral end of anterior cruciate ligament with classic femoral lateral loop plate fixation.@*METHODS@#A retrospective analysis of 65 patients who underwent arthroscopic anterior cruciate ligament reconstruction from January 2019 to September 2021 were performed. According to the different fixation methods of the femoral side, 35 patients were divided into loop plate fixation(loop plate group), including 27 males and 8 females, aged from 18 to 50 years old with an average of (35.00±7.60) years old;30 patients in interface screw fixation(interface screw group), including 20 males and 10 females, aged from 18 to 50 years old with an average of (32.00±8.50) years old. Hospital stay, hospital expenses, operation time, complications, C-reactive protein at 1, 3, 6 days after operation, and postoperative Lysholm score and International Knee Documentation Committee(IKDC) score at 18 months were compared between two groups.@*RESULTS@#All patients were successfully operated, and obtained follow-up from 18 to 36 months with an average of (25.16±4.50) months. Anterior drawer test and Lachman test of all patients turned to negative. There were no statistical differences in hospital stay, hospital expenses and complications between two groups(P>0.05);operation time in loop plate group was (74.00±6.84) min, and (91.67±6.34) min in interface screw group, and had difference between two groups(P<0.05). C-reactive protein on the 1st and 3rd day after operation was (40.00±10.10), (20.00±8.23) mg·L-1 in loop plate group, and (60.00±8.93), (30.00±8.66) mg·L-1 in interface nail group, had statistical difference between two groups (P<0.05);while there was no difference in C-reactive protein on the 6th day after operation(P>0.05). At 18 months after operation, Lysholm and IKDC scores showed no significant difference between two groups (P>0.05). In loop plate group, medullary enlargement on coronal and sagittal views were (2.75±0.19) mm, (1.55±0.25) mm, and (2.81±0.22) mm, (1.61±0.20) mm in interface screw group, and had statistical difference between two groups(P<0.05).@*CONCLUSION@#In the reconstruction of anterior cruciate ligament, the common interface screw on the femoral side is changed to the sheath interface screw, and intramedullary screw is changed to the compression and fixation of tendon from outside to inside of joint. Although the operation procedure is relatively complicated and operation time is slightly longer, it has advantages of no residual metal foreign body after operation, and clinical effect is no different from classical loop plate suspension fixation, which is still a good choice.

In Vitro Degradation Behavior of Absorbable Interface Screws / 中国医疗器械杂志

The composite material PLGA compounded with β-tricalcium phosphate (β-TCP) was prepared by melt blending method, and the absorbable interface screw was prepared by injection molding process. Prepare PBS buffer that simulates human body, conduct in vitro degradation experiments on interface screws according to relevant national and industry standards, then test and characterize interface screws at different time points for degradation of intrinsic viscosity, average molecular weight distribution, mass loss, mechanical properties and thermal properties. According to the degradation performance-time curve, determine the time node at which the interface screw loses the mechanical properties. In this paper, the in vitro degradation behavior of interfacial screws prepared from PLGA and β-TCP composites was studied in detail, providing a reference and basis for the degradation behavior of absorbable products prepared from PLGA and β-TCP composites.

The efficacy of absorbable interface screw combined with bone tunnel on knee ligament fractures / 中国医师进修杂志

Objective:To investigate the efficacy of absorbable interface screw combined with bone tunnel on knee ligament fractures.Methods:One hundred and twenty patients with fractures of anterior cruciate ligament (ACL) admitted to Shanxian Haijiya Hospital from January 2018 to April 2020 were selected and according to the random number table method, they were divided into the absorbable group and the metal group, with 60 cases in each group. They adopted absorbable interface screw combined with bone tunnel and metal screw combined with bone tunnel respectively. The clinical efficacy, Lysholm knee function score, bone broadening degree and the incidence of postoperative complications of the two groups were compared.Results:The excellent and good rate in the absorbable group was higher than that in the metal group: 93.33%(56/60) vs. 80.00%(48/60), χ2 = 4.62, P<0.05. After operation for 3 and 6 months, the Lysholm knee fuction scores in the absorbable group were higher than those in the metal group: (78.42 ± 5.26) scores vs. (70.41 ± 4.28) scores, (92.57 ± 6.34) scores vs. (88.26 ± 6.30) scores, the differences were statistically significant ( P<0.05). After operation for 6 months, the broadening degree of the bone tunnels of femur anteroposterior projection, femur lateral position, leg anteroposterior projection, leg lateral position in the absorbable group were lower than those in the metal group: (2.34 ± 0.55) mm vs. (3.18 ± 0.71) mm, (2.31 ± 0.42) mm vs. (3.20 ± 0.61) mm, (2.80 ± 0.77) mm vs. (3.23 ± 0.72) mm, (2.82 ± 0.51) mm vs. (3.22 ± 0.62) mm, the differences were statistically significant ( P<0.05). The incidence of postoperative complications in the absorbable group was lower than that in the metal group: 5.00%(3/60) vs. 16.67%(10/60), χ2 = 4.23, P<0.05. Conclusions:Absorbable interface screw combined with bone tunnel for ACL fractures can effectively improve clinical efficacy, promote knee joint rehabilitation, reduce postoperative bone canal width, and reduce the incidence of postoperative complications.