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Thome AP, O'Donnell R, DeFroda SF, et al. Effect of Skeletal Maturity on Fixation Techniques for Tibial Eminence Fractures. Orthop J Sports Med. 2021;9(11):23259671211049476doi: 10.1177/23259671211049476.
Thome, A. P., O'Donnell, R., DeFroda, S. F., Cohen, B. H., Cruz, A. I., Fleming, B. C., & Owens, B. D. (2021). Effect of Skeletal Maturity on Fixation Techniques for Tibial Eminence Fractures. Orthopaedic journal of sports medicine, 9(11), 23259671211049476. https://doi.org/10.1177/23259671211049476
Thome, Andrew P, et al. "Effect of Skeletal Maturity on Fixation Techniques for Tibial Eminence Fractures." Orthopaedic journal of sports medicine vol. 9,11 (2021): 23259671211049476. doi: https://doi.org/10.1177/23259671211049476
Thome AP, O'Donnell R, DeFroda SF, Cohen BH, Cruz AI, Fleming BC, Owens BD. Effect of Skeletal Maturity on Fixation Techniques for Tibial Eminence Fractures. Orthop J Sports Med. 2021 Nov 12;9(11):23259671211049476. doi: 10.1177/23259671211049476. eCollection 2021 Nov. PMID: 34796240; PMCID: PMC8593322.
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Orthop J Sports Med. 2021 Nov 12;9(11):23259671211049476. doi: 10.1177/23259671211049476. eCollection 2021 Nov.

Effect of Skeletal Maturity on Fixation Techniques for Tibial Eminence Fractures.

Orthopaedic journal of sports medicine

Andrew P Thome, Ryan O'Donnell, Steven F DeFroda, Brian H Cohen, Aristides I Cruz, Braden C Fleming, Brett D Owens

Affiliations

  1. Department of Orthopaedic Surgery, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island, USA.
  2. Department of Orthopaedic Surgery, Rush University School of Medicine, Chicago, Illinois, USA.
  3. Orthopedic Associates, Providence, Rhode Island, USA.

PMID: 34796240 PMCID: PMC8593322 DOI: 10.1177/23259671211049476

Abstract

BACKGROUND: Several fixation methods have been reported for the operative treatment of tibial eminence fractures. Previous biomechanical studies have demonstrated that suture fixation may be a stronger construct; however, the maturity status of these specimens was not scrutinized.

PURPOSE: To examine if suture fixation remains a biomechanically superior fixation method to screw fixation in both skeletally mature and immature specimens.

STUDY DESIGN: Controlled laboratory study.

METHODS: Sixteen total matched porcine (Yorkshire) knees (8 skeletally immature knees and 8 skeletally mature knees) were procured, and a standardized tibial eminence fracture was created. In each age-matched group of knees, 4 knees underwent randomization to fixation with 2 screws while 4 knees were randomized to fixation using a dual-suture technique. Once fixation was complete, the specimens underwent cyclic loading (200 cycles) in the anteroposterior plane of the tibia and load-to-failure testing, both with the knee positioned at 30° of flexion. Relevant measurements were recorded, and data were analyzed.

RESULTS: Among mature specimens, load to failure was 1.9 times higher in the suture fixation group compared with the screw fixation group (1318.84 ± 305.55 vs 711.66 ± 279.95 N, respectively;

CONCLUSION: These findings suggest that suture fixation may represent a better construct choice for fixation of tibial eminence fractures in the skeletally mature population. However, in the skeletally immature population, fixation with screws or suture may be equivalent. Displacement after cyclic loading did not appear to differ by fixation method, nor did stiffness.

CLINICAL RELEVANCE: A stronger fixation construct may be beneficial and allow for earlier range of motion to help potentially decrease postoperative stiffness. Clinical studies are warranted to see if these results may be replicated in humans.

© The Author(s) 2021.

Keywords: biomechanics; knee; pediatric sports medicine; tibial eminence fracture

Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: Funding for this study was obtained from the Rhode Island Orthopedic Foundation and the Natio

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