Plantaris tendon: a novel graft for anterolateral ligament reconstruction and additional reinforcement for anterior cruciate ligament autografts in combined reconstructive procedures

Josipović, Mario; Vlaić, Josip; Serdar, Jure; Šimunović, Marko; Nizić, Dinko; Schauperl, Zdravko; Bojanić, Ivan; Jelić, Mislav

doi:10.1007/s00167-020-05885-x

Cited by 13 publications

(10 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Despite the high material strength of the plantaris tendon, its small CSA and maximum load make it unlikely to be useful for intra-articular ACL reconstruction in isolation. However, Josipovic ´et al 22 examined concurrent reconstruction of the ACL and anterolateral ligament to restore additional rotational stability using semitendinosus and plantaris tendon autografts, respectively. Because the anterolateral ligament is injured in 90% of patients with ACL ruptures and plantaris autografts are reported for other reconstructive applications, 1,31 scope remains for future investigations into the expansion of allografts available to include the plantaris tendon.…”

Section: Discussionmentioning

confidence: 99%

“…19 The most common tendons used as allografts for ACL reconstruction include bone−patellar tendon–bone (BPTB), hamstring (semitendinosus with or without gracilis tendon), tibialis anterior, tibialis posterior, and Achilles tendon. 10,11 Additional tendons with use as autografts for a range of reconstructive applications, such as fibularis longus, 18 flexor hallucis longus, 28 plantaris, 1,22,31 and flexor digitorum longus, 16 may have uses as allografts for specific cases of ACL injury. The final decision on graft source and type needs to be personalized and cater to the functional demands and age of the patient (ie, withstand certain loads and be appropriately sized), but it is also heavily influenced by surgeon preference.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Challenging the Perceptions of Human Tendon Allografts: Influence of Donor Age, Sex, Height, and Tendon on Biomechanical Properties

Ashton

Blaker

Hartnell³

et al. 2023

Am J Sports Med

View full text Add to dashboard Cite

Background: The use of allograft tendons has increased for primary and revision anterior cruciate ligament reconstruction, but allograft supply is currently limited to a narrow range of tendons and donors up to the age of 65 years. Expanding the range of donors and tendons could help offset an increasing clinical demand. Purpose: To investigate the effects of donor age, sex, height, and specific tendon on the mechanical properties of a range of human lower leg tendons. Study Design: Descriptive laboratory study. Methods: Nine tendons were retrieved from 39 fresh-frozen human cadaveric lower legs (35 donors [13 female, 22 male]; age, 49-99 years; height, 57-85 inches [145-216 cm]) including: Achilles tendon, tibialis posterior and anterior, fibularis longus and brevis, flexor and extensor hallucis longus, plantaris, and flexor digitorum longus. Tendons underwent tensile loading to failure measuring cross-sectional area (CSA), maximum load, strain at failure, ultimate tensile strength, and elastic modulus. Results from 332 tendons were analyzed using mixed-effects linear regression, accounting for donor age, sex, height, and weight. Results: Mechanical properties were significantly different among tendons and were substantially greater than the effects of donor characteristics. Significant effects of donor sex, age, and height were limited to specific tendons: Achilles tendon, tibialis posterior, and tibialis anterior. All other tendons were unaffected. The Achilles tendon was most influenced by donor variables: greater CSA in men (β = 15.45 mm2; Šidák adjusted P < .0001), decreased maximum load with each year of increased age (β = −17.20 N per year; adjusted P = .0253), and increased CSA (β = 1.92 mm2 per inch; adjusted P < .0001) and maximum load (β = 86.40 N per inch; adjusted P < .0001) with each inch of increased height. Conclusion: Mechanical properties vary significantly across different human tendons. The effects of donor age, sex, and height are relatively small, are limited to specific tendons, and affect different tendons uniquely. The findings indicate that age negatively affected only the Achilles tendon (maximum load) and challenge the exclusion of donors aged >65 years across all tendon grafts. Clinical Relevance: The findings support including a broader range of tendons for use as allografts for anterior cruciate ligament reconstruction and reviewing the current exclusion criterion of donors aged >65 years.

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Challenging the Perceptions of Human Tendon Allografts: Influence of Donor Age, Sex, Height, and Tendon on Biomechanical Properties

Ashton

Blaker

Hartnell³

et al. 2023

Am J Sports Med

View full text Add to dashboard Cite

show abstract

“…However, the biomechanical properties of the double-folded plantaris tendon are comparable to those of the original medial patellofemoral ligament, and thus the plantaris tendon may be suitable for medial patellofemoral ligament reconstruction ( 9 ). The plantaris tendon displays excellent biomechanical properties for anterolateral ligament (ALL) reconstruction ( 18 ). After using a double-folded plantaris tendon in ALL reconstruction, during anterior cruciate ligament (ACL) repair, patients were able to perform normal rehabilitation without any restrictions.…”

Section: Discussionmentioning

confidence: 99%

Reconstruction of the lateral collateral ligament using the plantaris tendon after wide excision of soft tissue sarcoma of the knee: A case report

et al. 2023

View full text Add to dashboard Cite

An 83-year-old woman presented with a 1-year history of a growing mass on the lateral surface of the right knee. Magnetic resonance imaging revealed a large soft tissue tumor in the subcutis of the right knee. The mass in the right knee rapidly increased, due to hemorrhage from the tumor. A needle biopsy revealed that the diagnosis was synovial sarcoma. The patient underwent wide excision and lateral collateral ligament reconstruction using the plantaris tendon. The patient had a Musculoskeletal Tumor Society Score of 86% at the lateset follow-up. In conclusion, reconstruction of the lateral collateral ligament using the plantaris tendon may be useful for preserving the function of the knee joint after resection of the soft tissue due to sarcoma of the knee.

show abstract

“…Josipovic et al [ 53 ] presented a technique of ALLR using the ipsilateral plantaris longus tendon. A quintuple graft composed of a three-strand ST and a two-strand GT was used for ACLR and a two-strand plantaris longus graft, which substituted the ALL, sutured to the quintuple graft.…”

Section: Autograftsmentioning

confidence: 99%

Graft choices for anterolateral ligament knee reconstruction surgery: Current concepts

Chalidis¹,

Pitsilos²,

Kitridis³

et al. 2022

WJCC

View full text Add to dashboard Cite

The anterolateral ligament (ALL) is a primary structure of the anterolateral complex of the knee that contributes to internal rotational stability of the joint. Injury of the ALL is commonly associated with rupture of the anterior cruciate ligament. If left untreated, ALL lesions may lead to residual anterolateral rotational instability of the knee after anterior cruciate ligament reconstruction, which is a common cause of anterior cruciate ligament graft failure. The function of the ALL can be restored by lateral extraarticular tenodesis or anterolateral ligament reconstruction (ALLR). In the lateral extraarticular tenodesis procedure, a strip of the iliotibial band is placed in a non-anatomical position to restrain the internal rotation of the tibia, while in ALLR, a free graft is fixed at the insertion points of the native ALL. Gracilis and semitendinosus grafts have mainly been utilized for ALLR, but other autografts have also been suggested. Furthermore, allografts and synthetic grafts have been applied to minimize donor-site morbidity and maximize the size and strength of the graft. Nevertheless, there has been no strong evidence to fully support one method over another thus far. The present review presents a detailed description of the graft choices for ALLR and the current literature available in regard to the effectiveness and outcomes of published surgical techniques.

show abstract

Plantaris tendon: a novel graft for anterolateral ligament reconstruction and additional reinforcement for anterior cruciate ligament autografts in combined reconstructive procedures

Cited by 13 publications

References 27 publications

Challenging the Perceptions of Human Tendon Allografts: Influence of Donor Age, Sex, Height, and Tendon on Biomechanical Properties

Challenging the Perceptions of Human Tendon Allografts: Influence of Donor Age, Sex, Height, and Tendon on Biomechanical Properties

Reconstruction of the lateral collateral ligament using the plantaris tendon after wide excision of soft tissue sarcoma of the knee: A case report

Graft choices for anterolateral ligament knee reconstruction surgery: Current concepts

Contact Info

Product

Resources

About