Please use this identifier to cite or link to this item: http://hdl.handle.net/10397/26274
Title: Influence of screw length and diameter on tibial strain energy density distribution after anterior cruciate ligament reconstruction
Authors: Yao, J
Kuang, GM
Wong, DWC
Niu, WX
Zhang, M 
Fan, YB
Keywords: Anterior crucial ligament reconstruction
Screw diameter
Screw length
Strain energy density
Issue Date: 2014
Publisher: Springer
Source: Acta mechanica Sinica, 2014, v. 30, no. 2, p. 241-249 How to cite?
Journal: Acta mechanica Sinica 
Abstract: Postoperative tunnel enlargement has been frequently reported after anterior cruciate ligament (ACL) reconstruction. Interference screw, as a surgical implant in ACL reconstruction, may influence natural loading transmission and contribute to tunnel enlargement. The aims of this study are (1) to quantify the alteration of strain energy den-sity (SED) distribution after the anatomic single-bundleACL reconstruction; and (2) to characterize the influence of screw length and diameter on the degree of the SED alteration. A validated finite element model of human knee joint was used. The screw length ranging from 20 to 30mm with screw diameter ranging from 7 to 9mm were investigated. In the post-operative knee, the SED increased steeply at the extra-articular tunnel aperture under compressive and complex loadings, whereas the SED decreased beneath the screw shaft and nearby the intra-articular tunnel aperture. Increasing the screw length could lower the SED deprivation in the proximal part of the bone tunnel; whereas increasing either screw length or diameter could aggravate the SED deprivation in the distal part of the bone tunnel. Decreasing the elastic modulus of the screw could lower the bone SED deprivation around the screw. In consideration of both graft stability and SED alteration, a biodegradable interference screw with a long length is recommended, which could provide a beneficial mechanical environment at the distal part of the tunnel, and meanwhile decrease the bone-graft motion and synovial fluid propagation at the proximal part of the tunnel. These findings together with the clinical and histological factors could help to improve surgical outcome, and serve as a preliminary knowledge for the following study of biodegradable interference screw.
URI: http://hdl.handle.net/10397/26274
ISSN: 0567-7718
EISSN: 1614-3116
DOI: 10.1007/s10409-014-0027-8
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