A low-profile all-suture anchor construct provides comparable fixation to both spiked washer and bone staple for tibial-sided medial collateral ligament reconstruction: A cadaveric biomechanical study.

Abstract

To compare the biomechanical performance of an all-suture anchor construct to that of both a spiked washer and cancellous screw, and a bone staple in tibial-sided superficial medial collateral ligament (sMCL) reconstruction. A time-zero cadaveric biomechanical study was conducted using 24 human cadaveric tibia, with fresh-frozen peroneus longus allografts used for an sMCL reconstruction. Specimens were randomized to one of three treatment groups for tibial fixation being an all-suture anchor construct, spiked washer, or bone staple. A servohydraulic uniaxial testing machine was used to assess elongation after 1000 cycles at 20-50N, maximum load-to-failure (LTF), elongation at maximum LT, and modes of failure. Differences between groups were analyzed using one-way analysis of variance (ANOVA). No statistically significant differences were observed across the groups. Mean elongation after cyclic loading was 1.1 ​± ​0.7 ​mm in the all-suture anchor group, 0.6 ​± ​1.2 ​mm in the spiked washer group, and 1.1 ​± ​0.6 ​mm in the staple group (p ​= ​0.732). Mean maximum LTF was 132.1 ​± ​40.2N for the all-suture anchor group, 120.8 ​± ​54.9N for the spiked washer group, and 123.9 ​± ​64.1N for the staple group (p ​= ​0.605). Mean elongation at maximum LTF was 8.6 ​± ​4.1 ​mm for the all-suture anchor group, 8.7 ​± ​5.4 ​mm for the spiked washer group, and 10.8 ​± ​6.3 ​mm for the staple group (p ​= ​0.605). The mode of failure for all specimens was tendon pullout. The all-suture anchor construct demonstrated comparable performance to both the spiked washer and bone staple for tibial-sided sMCL reconstruction in this time-zero cadaveric biomechanical assessment. Level III.