University of Hertfordshire

By the same authors


  • Hadi Moeinnia
  • Amir Nourani
  • Amirhossein Borjali
  • Mahdi Mohseni
  • Narges Ghias
  • Hossein Korani
  • Mahmoud Chizari
View graph of relations
Original languageEnglish
JournalJournal of Knee Surgery
Early online date8 Sep 2020
Publication statusE-pub ahead of print - 8 Sep 2020


The goal of this study is to investigate the effects of tendon and cannulated drill bit diameter on the strength of the bone and site hold tendon inside (BASHTI) fixation technique for an anterior cruciate ligament (ACL) reconstruction. Bovine digital tendons and Sawbones blocks were used to mimic the ACL reconstruction. Mechanical strength of the specimens was measured using a cyclic loading continued by a single cycle pull-out load until failure to simulate the real post-surgical loading conditions. Finally, failure modes of specimens and ultimate failure load were recorded. The maximum possible tendon surface strain (i.e. tendon compression) for tendon diameters of 6, 7, 8, and 9 mm were 0.73, 0.8, 0.7, and 0.65, respectively. 80% of the specimens with tendon diameter of 6 mm and 20% of specimens with tendon diameter of 7 mm failed on the torn tendon. All samples with larger tendon diameters (i.e. 8 and 9 mm) failed on the fixation slippage. The maximum fixation strength according to the most suitable core bones for 6, 7, 8 and 9 mm tendons were 148±47 N (core 9.5 mm), 258±66 N (core 9.5 mm), 386±128 N (core 8.5 mm) and 348±146 N (core 8.5 mm), respectively. The mode of tendon failure was significantly influenced by the tendon diameter. Also, an increase in tendon compression (TC) raised the fixation strength for all tendon diameters; however, tendon over compression decreased the fixation strength for the 8 mm tendon group. Finally, an empirical equation was proposed to predict BASHTI fixation strength.


© 2020 Thieme Publishing Group. This is an accepted manuscript of an article accepted for publication in Journal of Knee Surgery;

ID: 22368603