The biomechanical strength of a hardware-free femoral press-fit method for ACL bone-tendon-bone graft fixation.

PURPOSE: The purpose was to investigate graft slippage and ultimate load to failure of a femoral press-fit fixation technique for anterior cruciate ligament (ACL) reconstruction. METHODS: Nine fresh-frozen knees were used. Standardized harvesting of the B-PT-B graft was performed. The femora were cemented into steel rods, and a tunnel was drilled outside-in into the native ACL footprint and expanded using a manual mill bit. The femoral bone block was fixed press-fit. To pull the free end of the graft, it was fixed to a mechanical testing machine using a deep-freezing technique. A motion capture system was used to assess three-dimensional micro-motion. After preconditioning of the graft, 1000 cycles of tensile loading were applied. Finally, an ultimate load to failure test was performed. Graft slippage in mm ultimate load to failure as well as type of failure was noted. RESULTS: In six of the nine measured specimens, a typical pattern of graft slippage was observed during cyclic loading. For technical reasons, the results of three knees had to be discarded. 78.6 % of total graft slippage occurred in the first 100 cycles. Once the block had settled, graft slippage converged to zero, highlighting the importance of initial preconditioning of the graft in the clinical setting. Graft slippage after 1000 cycles varied around 3.4 ± 3.2 mm (R = 1.3-9.8 mm) between the specimens. Ultimate loading (n = 9) revealed two characteristic patterns of failure. In four knees, the tendon ruptured, while in five knees the bone block was pulled out of the femoral tunnel. The median ultimate load to failure was 852 N (R = 448-1349 N). CONCLUSION: The implant-free femoral press-fit fixation provided adequate primary stability with ultimate load to failure pull forces at least equal to published results for interference screws; hence, its clinical application is shown to be safe.

Estimation of the interplay between groups of fast and slow muscle fibers of the tibialis anterior and gastrocnemius muscle while running.

Electromyograms recorded from the lower limbs of humans while running were submitted to a time/frequency analysis using wavelets. The results of the wavelet analysis yielded intensity spectra at every time point during the swing and the stance phase. It was previously shown that more or less high frequency components get activated during different periods of the movement. The purpose of this study was to test to what extent the spectra can be reconstructed by a linear superposition of two generating spectra that were associated to groups of fast and slow muscle fibers. The terms fast and slow do not only refer to the conduction velocity but also to the shape of the motor unit action potential and are used to characterize the groups in a broader sense. The principal component analysis of the spectra confirmed that a two dimensional spectral space was appropriate. A parametric spectral decomposition was used to extract the generating spectra within the two dimensional spectral space. The generating spectra were in turn used to compute the power with which the groups of muscle fibers contribute to the measured spectra and thus to the overall muscular activity. The power that was obtained for the different time points during the movement reflects the biomechanically important interplay between the groups of muscle fibers while running.

Gender dependent EMGs of runners resolved by time/frequency and principal pattern analysis.

A promising approach for the analysis of surface electromyograms is to use wavelets to determine the spectral distribution of the signal intensity at any time. The authors have recently proposed using non-linearly scaled wavelets to obtain intensity patterns, which reflect the spectral distribution at any given time point. Further analysis of intensity-patterns is greatly facilitated by representing them as linear combinations of a base set of principal-patterns. The weight with which each principal-pattern contributes to the intensity-pattern can be represented on a set of orthogonal axes that span a previously introduced pattern space. The purpose of the present study was to show how to use pattern space to discriminate and classify male and female runners based on the electromyograms of five muscles of the limb. The results showed that there were significant gender specific differences, which allowed more than a 95% correct classification of the subjects as males or females. Classification was possible irrespective of the shod condition while running. Gender specific differences occurred at well-defined time periods during the movement. Common to both genders was that spectral changes did not parallel the changes in total signal intensity.