Biomechanical evaluation of PCL reconstruction with suture augmentation

Grotting, John A.; Nelson, Trevor; Banffy, Michael B.; Yalamanchili, Dheeraj; Eberlein, Sam A.; Chahla, Jorge; Metzger, Melodie F.

doi:10.1016/j.knee.2020.01.004

Cited by 13 publications

(9 citation statements)

References 33 publications

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“…25 Another biomechanical study of 11 knees comparing PTT in all-inside versus transtibial single-bundle PCLR with or without suture tape reinforcement was performed. 12 Single-bundle all-inside PCLR without reinforcement restored normal PTT except at 90 of knee flexion. Suture tape reinforcement to the all-inside reconstruction construct resulted in statistically comparable PTT with the intact knees at all flexion angles.…”

Section: Discussionmentioning

confidence: 91%

“…11,37 A recent cadaveric study of all-inside PCLR with and without internal brace augmentation revealed that suture tape reinforcement improved initial stability by decreasing PTT to levels similar to the PCL-intact knee. 12 In another cadaveric biomechanical study, the addition of suture tape resulted in decreased total graft elongation and increased ultimate strength independent of suspensory versus interference fixation. 25 The purpose of our study was to compare (1) PCL laxity, (2) complication and reoperation rates, and (3) patientreported outcomes (PROs) after all-inside single-bundle PCLR with and without independent suture tape reinforcement at a minimum 2-year follow-up.…”

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confidence: 97%

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confidence: 97%

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Comparison of Posterior Cruciate Ligament Reconstruction Using an All-Inside Technique With and Without Independent Suture Tape Reinforcement

Therrien

Pareek

Song

et al. 2022

Orthopaedic Journal of Sports Medicine

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Background: Biomechanical studies support the use of suture tape reinforcement for limiting graft elongation and increasing strength in knee ligament reconstructions. Purpose: To compare posterior cruciate ligament (PCL) laxity, complication and reoperation rates, and patient-reported outcomes (PROs) after all-inside single-bundle PCL reconstruction (PCLR) with versus without independent suture tape reinforcement. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective cohort study of consecutive patients who underwent primary, all-inside allograft single-bundle PCLR with and without independent suture tape reinforcement at a single academic institution from 2012 to 2019. Medical records were reviewed for patient characteristics, additional injuries, and concomitant procedures. PRO scores (including the International Knee Documentation Committee [IKDC], Tegner activity scale, and Lysholm scores), bilateral comparison kneeling radiographs, and physical examination findings were collected at a minimum of 2 years postoperatively. Results: Included were 50 patients: 19 with suture tape reinforcement (mean age 30.6 ± 2.9 years) and 31 without suture tape reinforcement (control group; mean age 26.2 ± 1.6 years). One PCLR graft in the suture tape group failed. Posterior drawer examination revealed grade 1+ laxity in 4 of 19 (21%) of the suture tape cohort versus 6 of 31 (19%) of the control cohort ( P > .999). Bilateral kneeling radiographs showed similar side-to-side differences in laxity between the groups (suture tape vs control: mean, 1.9 ± 0.4 vs 2.6 ± 0.6 mm; P = .361). There were no statistically significant differences between the groups in postoperative IKDC (suture tape vs control: 79.3 vs 79.6; P = .779), Lysholm (87.5 vs 84.3; P = .828), or Tegner activity (5.6 vs 5.7; P = .562) scores. Conclusion: All-inside single-bundle PCLR with and without independent suture tape reinforcement demonstrated low rates of graft failure, complications, and reoperations, with satisfactory PROs at a minimum 2-year follow-up. Radiographic posterior tibial translation was comparable between the 2 groups.

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Section: Discussionmentioning

confidence: 91%

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confidence: 97%

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confidence: 97%

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Comparison of Posterior Cruciate Ligament Reconstruction Using an All-Inside Technique With and Without Independent Suture Tape Reinforcement

Therrien

Pareek

Song

et al. 2022

Orthopaedic Journal of Sports Medicine

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“…Biomechanical studies by Grotting et al and Trasolini et al have demonstrated reduced posterior tibial translation in cadavers with PCL suture augmentation when compared to PCL reconstruction. 17 , 29 Additionally, Otto et al analyzed a cohort of 14 patients with multi-ligament PCL tears and found that suture augmentation provided adequate restoration of posterior tibial translation when followed for 20 months. 18 Recently, Zhao et al expanded on these findings to demonstrate satisfactory posterior stability and patient reported outcomes at two-year follow-up in 33 patients with isolated or multiligament PCL tears.…”

Section: Discussionmentioning

confidence: 99%

Patient Reported Clinical Outcomes Following PCL Suture Augmentation in Patients with Multiligamentous Knee Injury: A Retrospective Observational Study

Fathi,

Thompson,

Bolia

et al. 2024

ORR

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Purpose To compare the patient-reported outcomes between patients with posterior cruciate ligament (PCL) reconstruction or repair alone versus PCL reconstruction or repair with internal bracing (IB) in the context of multi-ligament knee injuries (MLKI). Methods All patients who underwent surgical management of MLKI at two institutions between 2006 and 2020 were retrospectively identified and offered participation in the study. Patient reported outcomes were measured via three instruments: Lysholm Knee score, Multiligament Quality of Life (ML-QOL), and the Patient-Reported Outcomes Measurement Information System (PROMIS) computer adaptive testing (CAT). The postoperative outcomes and reoperation rates were compared between the internal bracing and non-internal bracing groups. Results Fifty-two patients were analyzed; 34 were included in the IB group (17.6% female; age 33.1 ±1.60 years), and 18 were included in the non-IB group (11.1% female; age 34.1 ±3.72 years). Mean follow-up time of the entire cohort was 1.44 ± 0.22 years (IB: 1.21 ± 0.18; non-IB: 2.1 ±0.65). There were no significant differences between PROMIS CAT [PROMIS Pain (54.4 ±1.78 vs 51.7 ±1.70, p=0.319), Physical Function (44.3 ±2.27 vs 47.9 ±1.52, p=0.294), Mobility (44.0 ±1.71 vs 46.1 ±2.10, p=0.463)], ML-QOL [ML-QOL Physical Impairment (40.7 ±4.21 vs 41.7±5.10, p=0.884), Emotional Impairment (49.2 ±4.88 vs 44.7±5.87, p=0.579), Activity Limitation (43.5 ±4.56 vs 31.5±3.62, p=0.087), Societal Involvement (44.9 ±4.96 vs 37.5 ±5.30, p=0.345)] and Lysholm knee score (61.8 ±4.55 vs 61.0 ±4.95, p=0.916) postoperatively compared to the non-IB group. Conclusion In this group of patients, function and patient-reported outcomes between patients treated with PCL reconstruction and repair without internal brace versus those with additional internal brace augmentation were not significantly different. Further research encompassing a larger patient sample is necessary to investigate the efficacy of the internal brace for PCL injury in the context of MLKI injuries.

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“…The former includes catgut [ 12 ], collagen [ 13 ], and chitin fiber [ 14 ]. The latter includes polyglycolic acid (PGA) [ 15 ], poly (p-dioxanone) (PDS) [ 16 ], poly (lactic-co-glycolic acid) (PGLA) [ 17 ], poly (trimethylene carbonate) (PTMC) [ 18 ], and polycaprolactone (PCL) [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

Effect of Squid Cartilage Chitosan Molecular Structure on the Properties of Its Monofilament as an Absorbable Surgical Suture

Tan

Rajoka

et al. 2022

Polymers

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Suture is an important part of surgery, and wounds closing after surgery remains a challenge for postoperative care. Currently, silk, linen fiber, and cotton are available in the market as non-absorbable suture biomaterials. So, there is an urgent need to develop a novel suture with advantageous characteristics compared to the ones available on the market. In present study, a series of ultra-high molecular weight chitosan with different DD and MV were prepared from squid cartilage by alkaline treatment and ultrasonic degradation. The corresponding chitosan monofilaments were prepared by a wet spinning process and were characterized as sutures. The effects of the DD and MV of chitosan on the properties of its monofilament were studied, including surface morphology, mechanical property, swelling ratio, ash content, in vitro enzymatic degradation, and in vitro cytotoxicity. According to the results, AS-85 was chosen to be the best suitable as an absorbable surgical suture, which was spun from squid cartilage chitosan with DD~85% and MV~1.2 × 106. The outcome of the present study might derive tremendous possibilities for the utilization of squid cartilage β-chitin for biomedical applications.

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Biomechanical evaluation of PCL reconstruction with suture augmentation

Cited by 13 publications

References 33 publications

Comparison of Posterior Cruciate Ligament Reconstruction Using an All-Inside Technique With and Without Independent Suture Tape Reinforcement

Comparison of Posterior Cruciate Ligament Reconstruction Using an All-Inside Technique With and Without Independent Suture Tape Reinforcement

Patient Reported Clinical Outcomes Following PCL Suture Augmentation in Patients with Multiligamentous Knee Injury: A Retrospective Observational Study

Effect of Squid Cartilage Chitosan Molecular Structure on the Properties of Its Monofilament as an Absorbable Surgical Suture

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