Finite element simulations of different hamstring tendon graft lengths and related fixations in anterior cruciate ligament reconstruction

Abstract

As one of the most frequently used grafts in anterior cruciate ligament (ACL) reconstruction, hamstring tendon (HT) grafts are prepared with different lengths and fixed by specific fixations in knee joints. However, there are incomplete studies to investigate both the joint kinematics and graft biomechanics in the ACL reconstructions with different HT graft lengths. In this paper, three different graft lengths (i.e., 30, 50, and 70 mm) were developed in the ACL reconstruction and analyzed using finite element method under two usual clinical test loads (i.e., 134 N anterior tibial drawer and pivot shift test load). The different mechanical properties of the corresponding fixations were also considered for each graft length. It was revealed that the change in HT graft length would cause different strain and stress results in the grafts, but did not greatly influence joint stabilities under the two clinical test loads. The graft reaction force at the femoral fixation was always greatly lower than that at the tibial fixation regardless of load and graft length. The comparison of stress and strain results also indicated that more graft tissues inside the femoral and tibial tunnels could decrease the stress and strain values at the femoral and tibial fixation sites, respectively.

A Numerical Investigation of Anatomic Anterior Cruciate Ligament Reconstruction

“…The obliquity of femoral holes was in the range of 69 to 76 degrees in the coronal view and in the range of 51 to 58.5 degrees in the sagittal view as per AMP technique [12] (Case-A). Similarly, coronal obliquity of the graft in the femoral tunnel was in the range of 72 to 78 degrees and sagittal obliquity was in the range of 59 to 69.5 degrees as per TT Technique [13] (Case-B). The angles are measured with respect to tibial plateau/axial plane [12].…”

A Review on Finite Element Modeling and Simulation of the Anterior Cruciate Ligament Reconstruction

“…Subsequently, femur rotation and translation, forces and moments, can be applied similar to ordinary FE knee simulations according to the studied application. Concerning the present selected studies, a 134 N anterior load was applied to the tibia in Suggs et al (2003), Peña et al (2005Peña et al ( , 2006, Wan et al (2011Wan et al ( , 2017, Wang et al (2015). A posterior force of 100 N was applied to the femur in different flexion angles in Naghibi et al (2020), while ten load cases, from 10 to 100 N, was tested in (Vairis et al, 2016) and an internal tibial torque of 2 Nm was applied in Ramaniraka et al (2007).…”

Effect of segment structures on the hydrolytic degradation behaviors of totally degradable poly(L‐lactic acid)‐based copolymers

“…In the past decades, poly( L ‐lactic acid) (P L LA), which derives from renewable resources such as corn and sugar beet, possesses a variety of desirable properties, including being biodegradable, biocompatible, outstanding mechanically strong, and so on . So far, P L LA‐based medical devices are used in the clinical applications including BioScrew®, Bio‐Anchor®, and Absorb BVS® . Nevertheless, its inherent weakness, such as poor toughness and slow degradation and high crystallinity, should be improved for some specific applications .…”

“…[4][5][6][7] So far, PLLA-based medical devices are used in the clinical applications including BioScrew ® , Bio-Anchor ® , and Absorb BVS ® . [8][9][10] Nevertheless, its inherent weakness, such as poor toughness and slow degradation and high crystallinity, should be improved for some specific applications. 11,12 Previous studies have reported that it took about 2-3 years for PLLA to be totally degraded in the body.…”