Arthroscopic and histologic analysis of human patellar tendon autografts used for anterior cruciate ligament reconstruction

Rougraff, Bruce T.; Shelbourne, K. Donald; Gerth, P. K.; Warner, J. P.

doi:10.1177/036354659302100219

Cited by 196 publications

(194 citation statements)

References 28 publications

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“…The arthroscopic appearances were ligamentous in all our cases, as others have reported [12,13]. Tension, volume and synovial cover correlated well with function, especially stability as measured by the KT-1000.…”

Section: Discussionsupporting

confidence: 82%

Evaluation of anterior cruciate reconstruction reinforced by the Kennedy ligament augmentation device

Asahina

Yamamoto

Muneta

et al. 1995

International Orthopaedics

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Fifty anterior cruciate ligament reconstructions with the Kennedy ligament augmentation device were examined arthroscopically and histologically 6 to 61 months after operation. The autogenous segments used were the quadriceps tendon in 13 and the semitendinosus tendon, with or without gracilis, in 37. The arthroscopic findings were rated as good in 31, fair in 15 and poor in 4, and there was correlation between these grades and KT-1000 measurements. The histological findings were graded as good in 17, fair in 26 and poor in 4; these did not correlate with the arthroscopic grades but with the time interval after reconstruction. Maturation of the autogenous augmented segment was found to progress with time, but took more than 3 years to become complete.

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Section: Discussionsupporting

confidence: 82%

Evaluation of anterior cruciate reconstruction reinforced by the Kennedy ligament augmentation device

Asahina

Yamamoto

Muneta

et al. 1995

International Orthopaedics

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“…The natural history of BPTB autografts has been well documented in animal experiments [2][3][4][5][6][7][8][9][10][11][12] and in biopsy studies in man [13][14][15] using histological and microvascular techniques. The transplanted patellar tendon undergoes changes in microstructure and structural properties.…”

mentioning

confidence: 99%

The influence of avascularity on the mechanical properties of human bone-patellar-tendon-bone grafts

Rupp

Seil

Kohn

et al. 2000

The Journal of Bone and Joint Surgery. British volume

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Our aim was to analyse the effect of avascularity on the morphology and mechanical properties (tensile strength, viscoelasticity) of human bone-patellar-tendon-bone (BPTB) grafts in vitro. These were harvested at postmortem and stored submerged in denaturated human plasma at a constant pH, pO 2 , pCO 2 , temperature and humidity under sterile conditions. Mechanical testing was performed two and four weeks after removal of the graft. The mean ultimate strength was 1085.7 ± 255.8 N (control), 1009.0 ± 314.9 N (two weeks cultured) and 1076.8 ± 414.8 N (four weeks cultured). There was no significant difference in linear stiffness or deformation to failure between the groups. There was a difference in viscoelasticity between the control group and the avascular grafts and the latter had significant lower peak load-to-load ratios after 15 minutes compared with the control group. After two and four weeks the graft contained viable fibroblasts. There was regular cellularity in the superficial layers and decreased cellularity in the midportion. The structure of the collagen including the crimp pattern appeared to be normal in polarised light.We conclude that avascularity does not significantly affect ultimate failure loads or stiffness of BPTB grafts. Slight changes in viscoelasticity were induced, but the significance of the increased stress relaxation is not fully understood.

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“…Cellularity, nuclear morphology, fibre alignment, and interfibrillar spaces were evaluated by light microscopy. Nuclear morphology was classified as linear, spindle, oblong, or round, according to the grading system reported by Rougraff et al 10 The other half of each specimen was used for transmission electron microscopy. Each was fixed in 2.5% glutaraldehyde and 2% paraformaldehyde and embedded in Epon 812.…”

Section: Methodsmentioning

confidence: 99%

Solvent-dried and gamma-irradiated tendon allografts in rats

Maeda

Horibe

Matsumoto

et al. 1998

The Journal of Bone and Joint Surgery. British volume

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We examined solvent-dried, gamma-irradiated (SD-R) allografts and fresh-frozen (FF) allografts mechanically and morphologically. Before transplantation, FF grafts were more than six times stronger than SD-R grafts. After four weeks, the tensile strength was about the same in both groups. At 24 weeks only collagen fibrils of small diameter were observed in the SD-R grafts while in FF grafts fibrils of small and intermediate diameter were seen. Clinically, we suggest that SD-R grafts could be used as a favourable alternative to FF grafts if care was taken regarding their initial mechanical weakness.J Bone Joint Surg [Br] 1998;80-B:731-6. Received 18 July 1997; Accepted after revision 8 January 1998 Allogeneic tendon grafts have been used successfully for ligament reconstruction. [1][2][3][4] Allografts eliminate morbidity at the harvest site and there is a shorter operating time. The disadvantages are the risk of transmission of disease and difficulties in storage and handling. The use of solventdrying and gamma irradiation could provide a solution to these problems. Solvent-dried and gamma-irradiated (SD-R) fascia lata allografts (Tutoplast Fascia lata; Biodynamics, Erlangen, Germany) have been used successfully to reconstruct collateral ligaments in the knee and ankle. 5,6We have found, however, that solvent-drying and gamma irradiation had adverse effects on their initial strength. 7Our aim was to examine the time course of the mechanical properties and the collagen fibril profile of SD-R allografts and to compare them with those of fresh-frozen (FF) allografts in a rat model of patellar tendon transplantation. Materials and MethodsWe used 16-week-old male Lewis rats (LEW/crj, Charles River, Japan) as donors and Wistar rats (Crj:Wistar, Charles River, Japan) as recipients.We harvested the medial half of the patellar tendon with a tibial bone block from both knees of 24 Lewis rats. The bone block was 4 mm wide and 8 mm long and the tendon graft 2.5 mm wide and 8 mm long. These grafts were randomly allocated to two groups, FF or SD-R. The latter were suspended in 3% hydrogen peroxide, and then dried with organic acetone followed by gamma irradiation (2.8 Mrads). This treatment has been confirmed to inactivate human immunodeficiency virus. 8 The FF grafts were stored at -80°C for two to five weeks before transplantation. At the time of transplantation FF grafts were thawed at room temperature and SD-R grafts were reconstituted in saline for 30 minutes. Each recipient rat was operated on under general anaesthesia by intravenous injection of ketamine to create defects in the medial half of the patellar tendon and the tibia of both legs which were then replaced with a graft. The tibial bone block was fixed with a 0.7 mm Kirschner wire and the proximal and lateral ends of the graft were sutured with 6-0 nylon thread. After transplantation, each animal was allowed free activity in the cage. Mechanical studies. Groups of three rats were killed at 4, 8, 12 and 24 weeks after transplantation and the transplanted patel...

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Arthroscopic and histologic analysis of human patellar tendon autografts used for anterior cruciate ligament reconstruction

Cited by 196 publications

References 28 publications

Evaluation of anterior cruciate reconstruction reinforced by the Kennedy ligament augmentation device

Evaluation of anterior cruciate reconstruction reinforced by the Kennedy ligament augmentation device

The influence of avascularity on the mechanical properties of human bone-patellar-tendon-bone grafts

Solvent-dried and gamma-irradiated tendon allografts in rats

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