Biomechanical comparisons of anterior cruciate ligament: reconstruction procedures with flexor tendon graft

Miyata, Kôji; Yasuda, Kazunori; Kondo, Eiji; Nakano, H; Kimura, Shoichi; Hara, Noriyuki

doi:10.1007/s007760070010

Cited by 48 publications

(37 citation statements)

References 17 publications

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“…The existence of different methods makes it difficult to compare results. Despite a lack of similar methods, however, the results obtained at present work were similar with others from literature (Ahmad et al, 2004;Milano et al, 2006;Miyata et al, 2000;Rodríguez et al, 2014;Shen et al, 2010).…”

Section: Discussionsupporting

confidence: 79%

Biomechanical performance of Bio Cross-Pin and EndoButton for ACL reconstruction at femoral side: a porcine model

et al. 2016

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Introduction: The method of graft fixation is critical in anterior cruciate ligament (ACL) reconstruction surgery. Success of surgery is totally dependent on the ability of the implant to secure the graft inside the bone tunnel until complete graft integration. The principle of EndoButton is based on the cortical suspension of the graft. The Cross-Pin is based on graft expansion. The aim of this study was to evaluate the biomechanical performance of EndoButton and Bio Cross-Pin to fix the hamstring graft at femoral side of porcine knee joints and evaluate whether they are able to support of loading applied on graft during immediate post-operative tasks. Methods: Fourteen ACL reconstructions were carried out in porcine femurs fixing superficial flexor tendons with Titanium EndoButton (n = 7) and with 6 × 50 mm HA/PLLA Bio Cross-Pin (n = 7). A cyclic loading test was applied with 50-250 N of tensile force at 1 Hz for 1000 cycles. The displacement was measured at 20, 100, 500 and 1000 load cycles to quantify the slippage of the graft during the test. Single-cycle load-to-failure test was performed at 50 N/mm to measure fixation strength. Results: The laxity during cyclic loading and the displacement to failure during single-cycle test were lower for the Bio Cross-Pin fixation (8.21 ± 1.72 mm) than the EndoButton (11.20 ± 2.00 mm). The Bio Cross-Pin (112.22 ± 21.20 N.mm -1 ) was significantly stiffer than the EndoButton fixation (60.50 ±10.38 N.mm -1 ). There was no significant difference between Bio Cross-Pin (failure loading: 758. 29 ± 188.05 N; yield loading: 713.67 ± 192.56 N) and EndoButton strength (failure loading: 672.52 ± 66.56 N; yield loading: 599.91 ± 59.64 N). Both are able to support the immediate post-operative loading applied (445 N). Conclusion: The results obtained in this experiment indicate that the Bio Cross-Pin technique promote stiffer fixation during cyclic loading as compared with EndoButton. Both techniques are able to support the immediate post-operative loading applied.

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Section: Discussionsupporting

confidence: 79%

Biomechanical performance of Bio Cross-Pin and EndoButton for ACL reconstruction at femoral side: a porcine model

et al. 2016

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“…Second, the main difference between this work and real clinical situations was the use of the porcine knee and flexor digital tendon. However, porcine studies have been conducted previously on ACL fixation and results have been shown that are not significantly different from those found with young human bone [12][13][14].…”

Section: Discussionmentioning

confidence: 87%

“…However, less data have been published on the mechanical properties of the tendon graft using these devices. Because young cadaver knees are difficult to obtain, and have a potential for disease transmission, the study was performed on porcine knees that had been proven to be suitable models for graft fixation, and similar to healthy human bone tissue, as the tissue properties of porcine flexor tendons are similar to human hamstring tendons [12][13][14]. The stability of the ACL reconstructed knee immediately postoperatively depended on the initial graft fixation.…”

Section: Discussionmentioning

confidence: 99%

Biomechanical Comparison of Cross-Pin and Endobutton-CL Femoral Fixation of a Flexor Tendon Graft for Anterior Cruciate Ligament Reconstruction—A Porcine Femur-Graft-Tibia Complex Study

Shen

Chang

Lee

et al. 2010

Journal of Surgical Research

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“…The femurs were kept frozen at −20°C and allowed to thaw for 24 h before testing. The use of porcine bone in this study is supported by Miyata [8] who showed that the ultimate fixation strength of metal interference screws is similar in porcine and human bone. In the literature [6][7][8], it is argued that for a parametric study such as ours, consistency is improved with the porcine model as porcine bone density varies less than that of elderly human bone.…”

Section: Specimensmentioning

confidence: 56%

Stiffness characteristics of hamstring tendon graft fixation methods at the femoral site

Benfield

Otto

Bagnall

et al. 2004

International Orthopaedics (SICOT)

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In ACL reconstruction, stiffness and strength of a tendon graft complex are important features for knee stability and rehabilitation. The fixation between tendon and bone is known to be one of the weakest components of the graft complex. We examined the tensile loaddisplacement characteristics of looped semitendinosus tendons in a porcine femoral tunnel. Two groups of six cadaveric semitendinosus tendons and porcine femurs were tested, secured with either an aperture or nonaperture fixation method. Constructs were tested at 1 mm/s until failure in a materials testing machine, which allowed force and displacement data to be recorded. The nonaperture fixation group was significantly less stiff for the first 4 mm of displacement and had significantly higher ultimate failure loads. Provided that adequate ultimate strength can be achieved, stiffness properties of a tendon graft will be improved by using aperture fixation in femoral-site ACL reconstruction.Résumé Dans la reconstruction du LCA la rigidité et la résistance du complexe greffe-tendon sont des éléments importants pour la stabilité du genou et la récupération fonctionnelle. La fixation entre le tendon et l'os est connue pour être un des maillons faibles de l'ensemble. Nous avons examiné les caractéristiques de l'élasticité sous traction de tendons du demi-tendineux insérés en boucle dans un tunnel fémoral porcin. Deux groupes de six tendons cadavériques ont été testés, amarrés par une fixation avec ou sans ouverture. Les constructions ont été testées à 1 mm/s jusqu'à la rupture avec une machine á traction qui permet d'enregistrer la force et le déplace-ment. Le groupe avec la fixation sans ouverture était significativement moins rigide pour les premiers 4 mm de déplacement et avait une charge de rupture nettement plus haute. A condition que la tension de rupture puisse être atteinte, les propriétés de rigidité d'une greffe tendineuse seront améliorées en utilisant la fixation avec ouverture au niveau du site fémoral dans la reconstruction du LCA.

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Biomechanical comparisons of anterior cruciate ligament: reconstruction procedures with flexor tendon graft

Cited by 48 publications

References 17 publications

Biomechanical performance of Bio Cross-Pin and EndoButton for ACL reconstruction at femoral side: a porcine model

Biomechanical performance of Bio Cross-Pin and EndoButton for ACL reconstruction at femoral side: a porcine model

Biomechanical Comparison of Cross-Pin and Endobutton-CL Femoral Fixation of a Flexor Tendon Graft for Anterior Cruciate Ligament Reconstruction—A Porcine Femur-Graft-Tibia Complex Study

Stiffness characteristics of hamstring tendon graft fixation methods at the femoral site

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