Load to Failure and Stiffness of Interference Screw vs Pulvertaft Weave for Distal Fixation in Peroneal Allograft Reconstruction.

MedStar author(s):
Citation: Foot & Ankle International. 42(1):83-88, 2021 Jan.PMID: 32969276Institution: MedStar Union Memorial HospitalDepartment: Curtis National Hand Center | Orthopaedic SurgeryForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Allografts/su [Surgery] | *Muscle, Skeletal/su [Surgery] | *Tendons/su [Surgery] | Biomechanical Phenomena | Bone Screws | Cadaver | Humans | Orthopedic Procedures | Transplantation, Homologous/mt [Methods]Year: 2021Local holdings: Available online from MWHC library: 1999 - present, Available in print through MWHC library: 1999 - 2006ISSN:
  • 1071-1007
Name of journal: Foot & ankle internationalAbstract: BACKGROUND: Allograft reconstruction of the peroneal tendons is an option for treatment of major tears of 1 or both peroneal tendons. No consensus on a superior distal fixation method has been reported. The purpose of the study was to compare load to failure and stiffness of a Pulvertaft weave (PTW) through a residual tendon stump to direct-to-bone interference screw (IS) fixation.CLINICAL RELEVANCE: The PTW and IS constructs were biomechanically similar, and these results suggest that both should be moderately overtensioned to compensate for an inherent decreased initial stiffness.CONCLUSION: The PTW technique yielded higher load to failure in comparison to IS. There was no difference in overall construct stiffness between both techniques. Both constructs demonstrated 19% decrease in stiffness compared to the intact state.METHODS: Fifteen pairs of long leg cadaver specimens were used. All grafts were secured proximally to the peroneus brevis myotendinous junction via a PTW technique. Distally, the tendons were either sutured to the peroneus brevis stump via PTW or secured to the base of the fifth metatarsal via IS. Stiffness (slope of force/displacement) was measured for the intact tendon and after reconstruction, and finally each specimen was loaded to failure.RESULTS: Mean load to failure was significantly higher in the PTW group compared with the IS group (373.6 +/- 265.5 N vs 150.1 +/- 93.1 N; P = .01). The PTW and IS groups had significantly lower stiffness compared with the intact specimens (P < .001). There was no statistical significance in stiffness between the 2 techniques (P = .96).All authors: Abbasi P, Abousayed MM, Bean BA, Coleman MM, Guyton GP, Thompson JMOriginally published: Foot & Ankle International. :1071100720952092, 2020 Sep 24Fiscal year: FY2021Digital Object Identifier: ORCID: Date added to catalog: 2020-10-06
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Journal Article MedStar Authors Catalog Article 32969276 Available 32969276

Available online from MWHC library: 1999 - present, Available in print through MWHC library: 1999 - 2006

BACKGROUND: Allograft reconstruction of the peroneal tendons is an option for treatment of major tears of 1 or both peroneal tendons. No consensus on a superior distal fixation method has been reported. The purpose of the study was to compare load to failure and stiffness of a Pulvertaft weave (PTW) through a residual tendon stump to direct-to-bone interference screw (IS) fixation.

CLINICAL RELEVANCE: The PTW and IS constructs were biomechanically similar, and these results suggest that both should be moderately overtensioned to compensate for an inherent decreased initial stiffness.

CONCLUSION: The PTW technique yielded higher load to failure in comparison to IS. There was no difference in overall construct stiffness between both techniques. Both constructs demonstrated 19% decrease in stiffness compared to the intact state.

METHODS: Fifteen pairs of long leg cadaver specimens were used. All grafts were secured proximally to the peroneus brevis myotendinous junction via a PTW technique. Distally, the tendons were either sutured to the peroneus brevis stump via PTW or secured to the base of the fifth metatarsal via IS. Stiffness (slope of force/displacement) was measured for the intact tendon and after reconstruction, and finally each specimen was loaded to failure.

RESULTS: Mean load to failure was significantly higher in the PTW group compared with the IS group (373.6 +/- 265.5 N vs 150.1 +/- 93.1 N; P = .01). The PTW and IS groups had significantly lower stiffness compared with the intact specimens (P < .001). There was no statistical significance in stiffness between the 2 techniques (P = .96).

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