A new technique for BTB tendon fixation in anterior cruciate ligament reconstruction.A bio mechanical study

BackhroundsMany grafts are used for ACL reconstruction with different methods of fixation. We have presented a new technique for BTB (bone-tendon-bone) graft preparation andcompared its biomechanical properties with the classic one to see if the suspensorymethod of fixation is applicable for BTB grafts.MethodsEight fresh frozenhumanBTBgraftswereprepared. Graftswererandomlydividedintotwoseparate groups. Each containing 4 grafts. In the first group grafts were preparedwith standard BTB graft method and in the second group grafts were prepared with newenfolded method. All the grafts were assembled in a universal testing machine for testingthe mechanical properties of the grafts. Maximum tensile strength, failure load andfailure mode were derived from machine and the values were compared in each group.ResultsMean failure load for classic group was 1660.25 and for enfolded group it was 1579.25(P = 0.25). Mean stiffness for classic group was 285.25 N/meter and for enfolded groupit was 268.75 N/ per meter (P = 0.1). In classic group, all failures happened at the boneligamentjunction. In the enfolded group, failures also occurred through the tendinoosseousjunction except for one caseConclusionsEnfolded BTB graft preparation had the same biomechanical indexes of classic method.Therefore this graft preparation method can be used for ACL ligament reconstructionsurgery with used of suspensory fixation by Endobutton.