Mechanical Analysis of Extra-Articular Knee Ligaments. Part two: Tendon grafts used for knee ligament reconstruction

Smeets, Karen; Bellemans, Johan; Scheys, Lennart; Eijnde, Bert O.; Slane, Joshua; Claes, Steven

doi:10.1016/j.knee.2017.07.011

Cited by 30 publications

(31 citation statements)

References 56 publications

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“…18,20,32,34,51,56 Adult hamstrings tendons seem to possess the strongest mechanical properties and have previously been shown to exhibit significantly higher elastic modulus (1036±312 MPa) and ultimate stress values (120.1±30.0 MPa) than other graft candidates, including the patellar tendon (417±107 MPa, 76.2±25.1 MPa). 48 This is in agreement with our data for a pediatric population, which showed that the semitendinosus tendons and ITBs are stronger and less compliant than the quadriceps or patellar tendons. We also found relatively large subject-subject variability in the mechanical data for our pediatric specimens, especially for the quadriceps tendon.…”

Section: Discussionsupporting

confidence: 93%

“…This could be attributed to donor factors such as age, sex, BMI, and physical activity level, which we could not control for due to the rarity of the donor cohort. Large variations in mechanical properties of adult tendons and ligaments have been previously reported in the literature 48 and has been further attributed to individual biological variation in collagen fiber maturity, fiber alignment, interfiber cross-linkages and fiber-matrix interaction. 33…”

Section: Discussionmentioning

confidence: 79%

“…6,21,35 This study characterized the mechanical behavior of the tissue at the mid-substance (ACL, patellar tendon, quadriceps tendon) or distal third substance (semitendinosus tendon, ITB) of the tendon or ligament with uniaxial ex vivo testing. Many factors that are known to contribute to the strength and durability of an ACLR graft in vivo , such as post-operative ligamentization and ligament anchoring, 48 were not considered. In addition, the anatomical direction of tension is not always axially directed.…”

Section: Discussionmentioning

confidence: 99%

“…Gaining a better understanding of these relationships will likely improve surgical outcomes in pediatric patients, particularly as ACLR procedure frequency continues to accelerate. 40 While many in vitro studies have examined the material properties of ACLs and common grafts used for knee ligament reconstruction in adults 48,49 and in skeletally immature animal models, 7,10,59 to our knowledge, no analogous studies have been conducted for the pediatric population. Therefore, the purpose of this study was to characterize the mechanical properties and microstructure of ACLs and the most common tendons used for pediatric ACLR.…”

Section: Introductionmentioning

confidence: 99%

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Mechanical and Microstructural Properties of Pediatric Anterior Cruciate Ligaments and Autograft Tendons used for Reconstruction

Schmidt

Chin

Aoyama

et al. 2018

Preprint

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5Background: Over the last several decades there has been a steady increase in pediatric ACL 6 tears, particularly in young female basketball and soccer players. Because allograft tissue for 7 pediatric ACL reconstruction (ACLR) has shown high rates of failure, autograft tissue may be the 8 best option for ACLR in this population. However, the differences in structure and mechanical 9 behavior of these tissues are not clear. 10Purpose: This study sought to characterize mechanical and microstructural properties in pediatric 11ACLs and autograft tissues using a rare cadaveric cohort (mean age 9.2 years). 12Study Design: Descriptive laboratory study. 13Methods: ACLs, patellar tendons, quadriceps tendons, semitendinosus tendons, and iliotibial 14 bands (ITBs) were harvested from five fresh-frozen pediatric knee specimens (3M, 2F) and 15 subjected to a tensile loading protocol. A subset of contralateral tissues were analyzed using 16 brightfield, polarized light, and transmission electron microscopy. was not peer-reviewed) is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity.The copyright holder for this preprint (which . http://dx.doi.org/10.1101/338905 doi: bioRxiv preprint first posted online Jun. 4, 2018; Conclusion: The mechanical properties of the patellar tendon were almost identical to that of the 24 ACL. The ITB exhibited increased strength and similar microstructure to the native ACL. These 25 findings are not entirely congruent to studies examining adult tissues. 26Clinical Relevance: Results suggest that ITB tissue may be the preferable choice as an autograft 27 tissue in pediatric ACL reconstructions. 28Key Terms: Pediatric, ACL reconstruction, mechanical properties, microstructural properties, 29 patella tendon grafts, quadriceps tendon grafts, hamstring grafts 30What is Known about the Subject: Due to the extreme rarity of pediatric cadaveric specimens, 31 very little is known about these tissues. INTRODUCTION 37A large amount of research has been devoted to characterizing the mechanical and 38 microstructural properties of the tendons and ligaments surrounding the adult human knee. Due to 39 the extreme rarity of these cadaveric specimens, relatively little is known about these properties in 40 the pediatric population. While the effects of senescent aging on the tensile properties of these 41 structures have been established, 22,35,58 extrapolating this data back to pre-pubescent ages is 42 inadequate. Over the past several decades, the clinical need for this data in pediatric orthopedics 43 has grown in parallel with the steady increase of diagnosed ligament tears in skeletally immature 44 patients. 3,11,27,36 This trend has been attributed to several factors, including increased participation 45 in youth sports, sport specialization, year-round play, and an increase in the number of adolescents 46All rights reserved. No reuse allowed without permission.was not peer-reviewed) is the author/funder, who has granted bioRxiv a license to display ...

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Mechanical and Microstructural Properties of Pediatric Anterior Cruciate Ligaments and Autograft Tendons used for Reconstruction

Schmidt

Chin

Aoyama

et al. 2018

Preprint

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“…This may be attributed to the difference in their grafts(the Mann procedure uses semitendinosus brevis tendon as graft, while the Schon procedure uses peroneus brevis tendon as graft). The elastic modulus and cross-sectional area of semitendinosus are 1036MPa and 20mm 2 , respectively [35,36]. The peroneus brevis tendon has an elastic modulus value of149.7 MPa and a cross-sectional area of about 19.5mm 2 [25].…”

Section: Discussionmentioning

confidence: 99%

Biomechanical comparison of tenodesis reconstruction for subtalar instability: a finite element analysis

Wang

et al. 2020

Preprint

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Background: There are several types of tenodesis reconstruction designed for subtalar instability.However, no comprehensive comparison has been conducted among these procedures in terms of their correcting power so far. The objective of this study is to evaluate the biomechanical behaviors of 5 representative procedures through finite element analysis. Methods: A finite element model was established and validated based on one of our previous studies. The Pisani interosseous talocalcaneal ligament(ITCL) reconstruction, Schon cervical ligament(CL) reconstruction and Choisne calcaneofibular ligament(CFL)reconstruction were compared on a model with the CFL, ITCL and CL sectioned. The Schon triligamentous reconstruction and Mann triligamentous reconstruction were compared on a model with the CFL, ITCL and CL, as well as the anterior talofibular ligament (ATFL) sectioned. The inversion and external/internal rotation were quantified in different ankle positions with rotational moment.Results: For single ligament reconstruction, the Choisne CFL reconstruction provided the greatest degree of correction for subtalar instability, followed by the Schon CL reconstruction and then the Pisani ITCL reconstruction. For triligamentous reconstruction, the Mann procedure outperformed the Schon procedure in alleviating the subtalar instability. Conclusion:The finite element analysis showed that the Choisne CFL reconstruction and Mann triligamentous reconstruction provided the greatest degree of immediate postoperative subtalar stability. However, both procedures could not restore the biomechanical behaviors of the subtalar joint to normal. The long-term efficacy of these procedures warrants further investigation using a substantially larger sample of clinical cases.

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Development of a Device for Maintaining the Temperature of the Tendons During the Period of Recovery

Grgić,

Karakašić,

Ivandić

et al. 2024

Lecture Notes in Networks and Systems

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Mechanical Analysis of Extra-Articular Knee Ligaments. Part two: Tendon grafts used for knee ligament reconstruction

Cited by 30 publications

References 56 publications

Mechanical and Microstructural Properties of Pediatric Anterior Cruciate Ligaments and Autograft Tendons used for Reconstruction

Mechanical and Microstructural Properties of Pediatric Anterior Cruciate Ligaments and Autograft Tendons used for Reconstruction

Biomechanical comparison of tenodesis reconstruction for subtalar instability: a finite element analysis

Development of a Device for Maintaining the Temperature of the Tendons During the Period of Recovery

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