In Vivo biomechanical evaluations of suture anchors for repairing grade 3 superficial medial collateral ligament injury in a porcine model

Abstract

Purpose: To clarify the biomechanical and radiological outcomes of superficial medial collateral ligament (sMCL) repair using suture anchors in a large animal model. Methods: The right sMCLs of nine male castrated pigs was completely detached at the femoral attachment. sMCL repair surgery was performed using two suture anchors. The same skin incision, sMCL exposure, and immediate wound closure were made at the left knee as a sham surgery. Magnetic resonance imaging was performed preoperatively and 4 weeks after surgery. The structural properties (upper yield load, maximum load, linear stiffness, and elongation at failure) of the femur-sMCL-tibia complex were determined. Results: During tensile testing, all the repaired sMCLs avulsed from the femoral attachment. There were no significant differences in the upper yield load, maximum load, linear stiffness, or elongation at failure between the groups 4 weeks after surgery or in the MRI-derived signal-to-noise quotients (SNQs) at the mid and tibial sMCL. The SNQs differed significantly at the femoral (2.7 ± 1.2 vs 0.3 ± 0.7; P = 0.00064) portions between groups. Conclusion: The injured sMCLs biomechanically recovered after surgery using suture anchors even though the SNQs were higher than those with native contralateral sMCLs. For clinical relevance, sMCL repair of grade 3 sMCL injuries using suture anchors was both safe and successful with less tissue dissection.

Comparison of Onlay Anchor Fixation Versus Transosseous Fixation for Lateral Extra-articular Tenodesis During Revision ACL Reconstruction

“…8,19,21 Clinical studies comparing onlay and intraosseus screw fixation are missing, but a recent animal study examined the biological properties of an onlay MCL fixation, which demonstrated nonsignificant differences when compared with the native MCL. 35 These results are in line with clinical data showing good to excellent results of ligament fixation using the anchor technique. 19,21 Another technical benefit of the aLET is the minimized risk of tunnel interference when performing a concomitant ACLR.…”

Relationship Between Achilles Tendon Stiffness Using Myoton PRO and Translation Using a Tensile Testing Machine: A Biomechanical Study of a Porcine Model

“…The present large-animal study showed that dynamic stiffness, measured using Myoton PRO, exhibited a moderate correlation with length change, measured using biomechanical machines, at both AT0 and AT2, consistent with the findings of the human AT study [ 15 ]. Biomechanical testing using tensile testing machines on porcine anterior cruciate and medial collateral ligaments has been reported [ 19 - 20 ]. Significant length changes, as observed with the long-axis method, indicate greater translation of the tissue and softer tissue.…”

“…Sutures were then placed proximal to the AT. The calcaneus was inserted into aluminum tubes with cement [ 19 - 20 ].…”

“…The change in length during the cyclic loading was recorded. These conditions have been frequently used for measurements in previous studies using large-animal models [ 19 - 20 ].…”

Material Properties of Suture Augmentation of Knee Medial Collateral Ligament Repair Did Not Influence Length Changes or Failure Loads in a Caged Porcine Model

“…15 scalpel to create an avulsion injury ( Fig 1 B). 9 , 13 sMCL repair was performed using 2.0 nylon thread ( Fig 1 C) intended only to reduce the detached sMCL to its anatomic position, followed by UHMWPE tape augmentation by loading suture augmentation (ULTRATAPE; Smith & Nephew Endoscopy, Andover, MA) and 2 interference screws (Cannu-Flex SILK; Smith & Nephew Endoscopy). The initial tension of 30 N was applied to the suture augmentation, and sutures from the femoral sMCL anchor were secured to the anatomic tibial insertion of the MCL ( Fig 2 ).…”