Effects of Braiding on Tensile Properties of Four-Strand Human Hamstring Tendon Grafts

Millett, Peter J.; Miller, Bruce S.; Close, Matthew; Sterett, William I.; Walsh, William R.; Hawkins, Richard J.

doi:10.1177/03635465030310051301

Cited by 18 publications

(13 citation statements)

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“…One step produces a tension of about 150 N on the ACL whilst walking and about 450 N whilst running. In order to meet the specifications of an ACL reconstruction, a transplant is expected to be able to support a load of 500 N. In this study, the tensile-strength breaking values are all well below 500 N. These values remain much lower than in other cadaveric study publications [10], with values up to 4546 N for maximum load and 490 N/ mm for rigidity [12]. These differences can be explained by the advanced average age of the subjects, compared to patients featured in clinical practice [13].…”

Section: Discussionmentioning

confidence: 71%

“…These differences can be explained by the advanced average age of the subjects, compared to patients featured in clinical practice [13]. It can also be explained by the fact that most of the biomechanical studies on tendons do not use the same measuring systems or protocols [7,8,10] and, therefore, with different loading rates, the viscoelastic properties of the tendons can be modified [10].…”

Section: Discussionmentioning

confidence: 99%

“…The explanation lies in the freeze-induced cellular dehydration of the tissues, which modifies their elastic properties. To overcome this phenomenon, the tendons were refrozen in compresses soaked in saline solution as recommended by current experimental protocols [10,15].…”

Section: Discussionmentioning

confidence: 99%

“…The tibial insertion pedicle was then cut to free the transplant for biomechanical testing. The mean length of the grafts was 70.3 mm [45-90] and the mean diameter was 9.2 mm [8][9][10]. There were no significant differences between the groups for both length and thickness.…”

Section: Methodsmentioning

confidence: 99%

“…To prevent desiccation, the tendons were moistened and wrapped in saline-soaked gauze sponges. The sponges were then wrapped in aluminium foil, placed in an airtight bag, and stored at − 20°C until further use [10].…”

Section: Methodsmentioning

confidence: 99%

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Biomechanical effects of stitches on the intra-articular mid-substance of quadruple hamstring-tendon grafts for anterior cruciate ligament reconstruction – a pilot comparative cadaveric study

Saur

Clavert

Bonnomet

et al. 2020

Knee Surg & Relat Res

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Background: There is little data in the literature regarding the preparation methods of the intra-articular portion of quadruple hamstring-tendon grafts for anterior cruciate ligament (ACL) reconstruction. The aim of this study was to compare the biomechanical properties of a sutured transplant to that of a non-sutured transplant. The hypothesis was that adding stitches to the intra-articular portion of the graft increased its resistance. Method: A comparative cadaveric study was carried out on five pairs of knees. The average age of the cadavers was 68 years. The exclusion criterion was past knee surgery. In the Sutured Group (SG) two stitches were made on the grafts. No stitches were made on the grafts of the Non-sutured Group (NSG). A tensile failure test was carried out using an Instron® loading machine. The maximal load to failure and stiffness were recorded and we observed the mode of failure for each graft. Statistical analysis was performed using the Wilcoxon rank sum test. Level of significance was set at p < 0.05. Results: The hypothesis proposed was not confirmed; adding stitches to the intra-articular portion of the fourstrand hamstring-tendon graft does not increase its biomechanical properties. The maximal load to failure was 233.5 N ± 40.6 (186.7-274.5 N) for the NSG, 19.6% higher than for the SG which was 195.2 N ± 42.9 (139.0-238.2 N). Nevertheless, the difference observed was not statistically significant (p = 0.188). The stiffness of the grafts for the NSG was 23.5 N/mm ± 5.3 (17.8-29 N/mm) and 19.7 N/mm ± 5.5 (13.2-24.7 N/mm) for the SG grafts. Overall stiffness values for the NSG were 19% higher than those of the SG; however, the results were not statistically significant (p = 0.438). The failure mode was a rupture at the fixation point except for one sample from the SG which failed at an intra-articular stitch.

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Section: Discussionmentioning

confidence: 71%