Biomechanical Comparison of a Novel PEEK Tibial Cortical Suspension Device With 6 Metallic Femoral Cortical Suspension Devices Used in Anterior Cruciate Ligament Reconstruction
Year: 2025
Type: article
Abstract: Background: Conventional cortical suspensory fixation devices (CSFDs) are made of metal. Most adjustable-loop CSFDs originally intended for femoral-side fixation are also used on the tibial side during "all-inside" anterior cruciate ligament (ACL) reconstruction. The T-Button-A is a novel adjustable-loop polyether ether ketone (PEEK) CSFD intended specifically for tibial-side fixation during ACL reconstruction using the "full-tunnel" technique. Purpose/Hypothesis: The purpose of this study was to compare the biomechanical characteristics of the T-Button-A with those of 6 commercially available fixed- or adjustable-loop CSFDs. It was hypothesized that the T-Button-A would be comparable with conventional metallic CSFDs intended for femoral-side fixation in terms of its biomechanical properties. Study Design: Controlled laboratory study. Methods: Ten implants each, of T-Button-A, Tightrope RT, Proloop Ultra, Procinch RT, Infinity, Infiloop, and Endobutton CL Ultra were biomechanically tested using an axial and torsion testing machine, and an incremental load-based testing protocol comprising 3500 cycles. Elongation and load to failure on cyclic and pull-to-failure loading, respectively, were recorded for each implant and compared across all devices. The consistency of implants in completing the 3500 test cycles, and demonstrating cyclic elongation <3 mm as well as load to failure >650 N, was compared across the tested devices. Results: = .002), and comparable with that of Proloop Ultra and Infiloop. All 10 T-Button-A, Tightrope RT, Proloop Ultra, Infiloop, and Endobutton CL Ultra consistently completed the testing protocol and delivered elongation and load-to-failure values <3 mm and >650 N, respectively. Conclusion: The biomechanical performance of the T-Button-A is comparable with most fixed- and adjustable-loop metallic CSFDs and is beyond what is considered acceptable to support ACL reconstruction grafts during early postoperative rehabilitation. Clinical Relevance: The PEEK T-Button-A is a viable alternative to conventional metallic CSFDs, for tibial-side fixation during ACL reconstruction.
Institution: Medicover Hospitals
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,500
OpenAlex ID: W4409355502