In-line Pullout Strength of 2 Acetabular Fixation Methods for Ligamentum Teres Reconstruction of the Hip: A Cadaveric Study
Authors: Lall AC, Ankem HK, Ryan MK, Beason DP, Diulus SC, Roach RP, Rosinsky PJ, Maldonado DR, Emblom BA, Domb BG
DOI: 10.1177/23259671211052533
Background
Ligamentum teres reconstruction addresses full-thickness LT tears causing hip instability. The strength and reliability of acetabular graft fixation are critical for success, but optimal fixation technique remains unclear.
Methods
This cadaveric biomechanical study compared two fixation techniques for LT reconstruction: suture button fixation vs. knotless anchor fixation. Pullout strength and stiffness were measured on seven specimens.
Key Findings
- Suture button fixation demonstrated significantly higher pullout strength (load to failure) compared to knotless anchors.
- No significant difference in stiffness was found between the two methods.
Conclusions
Suture button fixation offers superior graft fixation strength for LT reconstruction compared to knotless anchors, which may translate to better postoperative hip stability.
What Does This Mean for Providers?
- Consider favoring suture button fixation for ligamentum teres reconstruction to maximize graft security and reduce risk of fixation failure.
- Although stiffness was similar, the higher pullout strength suggests suture buttons may better withstand physiological loading.
- Understanding fixation biomechanics can guide surgical technique selection to improve patient outcomes.