Anterior cruciate ligament (ACL) injuries, if left untreated, often produce significant disability in the athletically active population. Currently, autogenous tissue is the most commonly used substitute for ACL reconstruction because its immunogenicity is virtually nonexistent. However, the functional amount of autogenous tissue available for transplantation is limited. Additionally, this transplantation procedure may create a defect at the donor site, which can result in functional disability. To address these concerns, a prototype xenograft ligament prosthesis, epoxy-fixed porcine Achilles tendon, was developed. This study was intended to investigate the crosslinking characteristics of the epoxy-fixed porcine tendon. The fresh and glutaraldehyde-fixed porcine Achilles tendons were used as controls. Fresh porcine Achilles tendons procured from a slaughterhouse were used to fabricate the ligament prostheses. A 4% epoxy (ethylene glycol diglycidyl ether) solution or a 0.625% glutaraldehyde solution was employed to fix the porcine tendons. Samples of each group were taken out at various elapsed fixation periods. The crosslinking characteristics- denaturation temperature, moisture content, and fixation index-of each sample were then determined. In the study, it was learned that the crosslinking rate for the glutaraldehyde fixation was faster than that for the epoxy fixation. While the denaturation temperatures and the fixation indices for both studied groups were higher than for the fresh one, the denaturation temperature of the glutaraldehyde-fixed tendon was relatively higher than its epoxy-fixed counterpart. However, the fixation index and the moisture content for both studied groups were comparable. Also, it was noted that the epoxy-fixed tendon appeared more natural as compared to its glutaraldehyde-fixed counterpart. The implications of these findings for the epoxy-fixed tendon in the clinical ACL reconstruction require further investigation.
Biological materials have been used as prosthetic devices such as heart valves, vascular grafts, and pericardial patches. These biological materials have to be fixed with crosslinking reagents and sterilized subsequently before they can be implanted in humans. Recently, a new crosslinking reagent, epoxy compound, has been used to fix bioprostheses. In this fixation technique, heparin may be ionically bound on the tissue surface. It has been shown that the amount of heparin bound to the tissue surface is proportional to the quantity of protamine impregnated in the biological tissues. However, it is not known if the impregnation of protamine will affect the crosslinking density of the biological tissues. This study was designed to compare the crosslinking densities of the epoxy compound fixed biological tissues with or without heparinization. Fresh porcine aortic valves procured from a slaughter house were first impregnated in various concentrations of protamine sulfate (0, 0.5, 1.0, or 1.5%) for about 30 min. The porcine aortic valves were then crosslinked in a 4% epoxy compound solution (Denacol EX-313). The porcine samples were taken out at various elapsed fixation periods: 18, 25, 48, 72, 96, and 120 h. Finally, the crosslinked porcine aortic valves were heparinized in a 0.5% sodium heparin solution for about 1 h. The crosslinking densities of the porcine leaflet and the aortic wall of each sample were determined by measuring their shrinkage temperatures. It was revealed that the impregnation of various concentrations of protamine did not seem to significantly alter the shrinkage temperatures of the porcine leaflet and the aortic wall throughout the entire fixation process (p > 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
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