Biomechanical properties of common graft choices for anterior cruciate ligament reconstruction: A systematic review

Malige, Ajith; Baghdadi, Soroush; Hast, Michael W.; Schmidt, Elaine C.; Shea, Kevin G.; Ganley, Theodore J.

doi:10.1016/j.clinbiomech.2022.105636

Cited by 18 publications

(22 citation statements)

References 45 publications

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“…For HT autograft, harvested from the semitendinosus and/or gracilis tendon, there is wide variability in graft configurations ranging from one to eight strands, with quadrupled hamstring being the most common [ 75 ]. While BPTB and QT autograft are generally consistent in terms of length and thickness, hamstring tendons are correlated with patients’ anthropometrics and sports activity level and are therefore patient-dependent [ 89 , 121 ].…”

Section: Anatomy and Microstructural Propertiesmentioning

confidence: 99%

“…The ultimate load to failure of BPTB autograft ranges from 319 to 4389 N, with the highest load reported in 15 mm-wide grafts [ 75 ]. In clinical practice, 10 mm-wide grafts with ultimate loads to failure of 1880 to 2664 N are typically used [ 26 , 50 , 111 ].…”

Section: Biomechanicsmentioning

confidence: 99%

“…Similarly, the ultimate load to failure for a 10 to 12 mm-wide QT autograft ranges from 249 to 2186 N [ 50 , 75 , 111 ]. QT autograft with bone block, as well as full-thickness grafts appear to have higher ultimate loads to failure compared to all-soft tissue or partial thickness grafts [ 111 ].…”

Section: Biomechanicsmentioning

confidence: 99%

“…For HT autograft, graft configuration (including total number of strands) correlates with graft size, which is in turn positively correlated with tensile strength [ 14 ]. Depending on graft configuration, graft diameters ranging from 6 mm to over 10 mm can be obtained with ultimate loads to failure ranging from 225 to 4590 N [ 50 , 75 , 111 ]. While a graft should have a minimum thickness of 8 mm, increased graft CSA is associated with an increased complication risk due to notch and PCL impingement [ 49 , 74 , 76 , 89 ].…”

Section: Biomechanicsmentioning

confidence: 99%

“…For BPTB grafts, stiffness is reported to range from 158 to 685.2 N/mm, with values between 324 and 543 N/mm for grafts of 10 mm width [ 3 , 75 , 111 ]. For QT, stiffness is reported to be between 17.0 and 809.0 N/mm, with the smallest values seen by Noyes et al when testing a quadriceps tendon-patellar retinaculum-patellar tendon graft construct [ 83 ].…”

Section: Biomechanicsmentioning

confidence: 99%

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Current trends in graft choice for anterior cruciate ligament reconstruction – part I: anatomy, biomechanics, graft incorporation and fixation

et al. 2023

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Graft selection in anterior cruciate ligament (ACL) reconstruction is critical, as it remains one of the most easily adjustable factors affecting graft rupture and reoperation rates. Commonly used autografts, including hamstring tendon, quadriceps tendon and bone-patellar-tendon-bone, are reported to be biomechanically equivalent or superior compared to the native ACL. Despite this, such grafts are unable to perfectly replicate the complex anatomical and histological characteristics of the native ACL. While there remains inconclusive evidence as to the superiority of one autograft in terms of graft incorporation and maturity, allografts appear to demonstrate slower incorporation and maturity compared to autografts. Graft fixation also affects graft properties and subsequent outcomes, with each technique having unique advantages and disadvantages that should be carefully considered during graft selection.

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Section: Anatomy and Microstructural Propertiesmentioning

confidence: 99%

Section: Biomechanicsmentioning

confidence: 99%

Section: Biomechanicsmentioning

confidence: 99%

Section: Biomechanicsmentioning

confidence: 99%

Section: Biomechanicsmentioning

confidence: 99%

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Current trends in graft choice for anterior cruciate ligament reconstruction – part I: anatomy, biomechanics, graft incorporation and fixation

et al. 2023

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Combined ACLR and lateral extra‐articular tenodesis with a continuous iliotibial band autograft is a viable option in a population of athletes who participate in pivoting sports

Lutz,

Casin,

Pioger

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeThe aim of this study was to evaluate the clinical results, return to sport and complications after anterior cruciate ligament reconstruction (ACLR) associated with lateral extra‐articular tenodesis using continuous plasty with an iliotibial band.MethodsThis was a prospective multicentre study involving 186 patients who had surgery for anterior cruciate ligament (ACL) rupture. Patients with multiligament ruptures and revision surgery were excluded from the study. All patients included were involved in pivoting sports and wished to resume their activity after surgery. Patients were assessed at a minimum 2‐year follow‐up using functional and psychological questionnaires (subjective International Knee Documentation Committee [IKDC], Tegner, Lysholm and ACL‐RSI scores), ligament assessment including instrumented laxity measurement (Rolimeter), Lachman test and pivot shift and isokinetic testing. Return to sport was assessed using a questionnaire, and complications and repeat surgeries were recorded.ResultsAt a mean follow‐up of 43.1 months, the subjective IKDC, Lysholm, ACL‐RSI and objective IKDC scores were significantly improved (59.8 vs. 94.5 p < 0.0001, 75 vs. 99 p < 0.0001, 60 vs. 93 p < 0.0001, IKDC A 0% vs. 72%, B 12% vs. 27%, C 60% vs. 1% D 28% vs. 0% p < 0.0001). The Tegner activity level was 9 (3–10) before the accident and 9 (3–10) at the last review. Seventy‐six percent of the patients had returned to sports at the same level. The differential laxity was 6.6 mm (±1.7) preoperatively and 1.1 mm (±1.4) postoperatively. Additionally, 97% were equal in pivot shift at the last follow‐up. At the 6‐month isokinetic assessment, the muscle strength recovery for the quadriceps and hamstring was over 85% compared with the healthy side for 79% and 70% of the patients, respectively. Ten patients had graft rupture (5.6%). Four (2.4%) patients had a contralateral ACL rupture, and seven (4%) underwent a reoperation with meniscectomy.ConclusionAnterior ligament reconstruction with lateral extra‐articular tenodesis using a continuous strip of iliotibial band enables 76% of patients in a population with a high demand for sports to resume their activities at the same level. The clinical results and complication rates, particularly reruptures (5.6%), were similar to those of other techniques involving lateral extra‐articular tenodesis.Level of EvidenceLevel II.

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Entnahme eines „split graft“ des Peroneus longus für die rekonstruktive Bandchirurgie am Kniegelenk

Zhou,

Petersen

2024

Arthroskopie

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Biomechanical properties of common graft choices for anterior cruciate ligament reconstruction: A systematic review

Cited by 18 publications

References 45 publications

Current trends in graft choice for anterior cruciate ligament reconstruction – part I: anatomy, biomechanics, graft incorporation and fixation

Current trends in graft choice for anterior cruciate ligament reconstruction – part I: anatomy, biomechanics, graft incorporation and fixation

Combined ACLR and lateral extra‐articular tenodesis with a continuous iliotibial band autograft is a viable option in a population of athletes who participate in pivoting sports

Entnahme eines „split graft“ des Peroneus longus für die rekonstruktive Bandchirurgie am Kniegelenk

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