Evaluation of biomechanical properties: are porcine flexor tendons and bovine extensor tendons eligible surrogates for human tendons in in vitro studies?

Domnick, Christoph; Wieskötter, Britta; Raschke, Michael J.; Schulze, Martin; Kronenberg, Daniel; Wefelmeier, M.; Langer, Martin; Herbort, Mirco

doi:10.1007/s00402-016-2529-2

Cited by 75 publications

(68 citation statements)

References 33 publications

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“…Both porcine flexor tendons and the mechanical setup in this study have been used in other investigations on the strength of suture-tendon constructs [12,[20][21][22][23]. Freezing the samples for storage might have influenced the material properties, but the tensile force gets lower because of freezing [20]. This effect only supports our statement positively.…”

Section: Discussionsupporting

confidence: 47%

“…However, Domnick et al could demonstrate that for biomechanical investigations, fresh-frozen porcine flexor tendons represent an appropriate substitute for human semitendinosus tendons [20]. Both porcine flexor tendons and the mechanical setup in this study have been used in other investigations on the strength of suture-tendon constructs [12,[20][21][22][23].…”

Section: Discussionmentioning

confidence: 95%

“…The samples were thawed to room temperature for 12 h before the testing and cut to a length of 24 cm. Fresh-frozen porcine flexor tendons were used based on availability and comparable biomechanical properties compared to human tendons [20] and they had been established for similar testing setups in previous studies [21][22][23].…”

Section: Samplesmentioning

confidence: 99%

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The single-suture technique for anterior cruciate ligament graft preparation provides similar stability as a three-suture technique: a biomechanical in vitro study in a porcine model

Theopold¹,

Schleifenbaum

Georgi³

et al. 2020

Arch Orthop Trauma Surg

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Purpose Numerous techniques have been described for the tibial-sided graft preparation in anterior cruciate ligament (ACL) reconstruction. The use of less suture material for graft preparation is thought to improve ingrowth and to reduce the risk for infection. At the same time, the suture construct should be strong enough to resist the surgeon's pull during tensioning of the transplant. Methods In total, 39 fresh-frozen procine deep flexor tendons were used and prepared as four-strand grafts. In the three-suture group (n = 19), graft preparation was performed using three tibial-sided sutures, with each tendon end sutured separately. In the one-suture group (n = 20), a modified graft preparation using only one tibial-sided suture was applied. Each sample underwent load-to-failure testing (N max ) after cyclic pre-loading. To estimate intraoperative tension forces acting on the tibial-sided suture constructs, the maximal tension force of 26 volunteers on such a construct was measured using a load cell. Results The biomechanical testing of the two different suture constructs showed a significantly higher load-to-failure for the three-suture group (711 N ± 91 N) compared to the one-suture group (347 N ± 24 N) (p = 0.0001). In both groups, the mode of failure was a tear of the suture in all samples. A failure of the suture-tendon interface was not observed in any case. The median maximal tension force on the construct applied by the 26 volunteers was 134 N (range 73-182 N). Conclusion The presented single-suture tendon graft preparation resisted to smaller failure loads than the conventional three-suture technique. However, no failures in the suture-tendon interface were seen and the failure loads observed were far beyond the tension forces that can be expected intraoperatively. Hence, the single-suture graft preparation technique may be a valuable alternative to the conventional technique.Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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Section: Discussionsupporting

confidence: 47%

Section: Discussionmentioning

confidence: 95%

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The single-suture technique for anterior cruciate ligament graft preparation provides similar stability as a three-suture technique: a biomechanical in vitro study in a porcine model

Theopold¹,

Schleifenbaum

Georgi³

et al. 2020

Arch Orthop Trauma Surg

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“…First, porcine flexor profundus tendons were used for the experiment, rather than human tendons. Domnick et al [5] reported that porcine flexor tendons had similar stiffness and type I collagen concentrations compared with human cadaveric semitendinosus tendons, although failure loads were higher, they proposed that porcine flexor tendons are a reasonable surrogate for human semitendinosus tendons. Second, because a single type of suture material was used in this study, no information regarding the potential change in the mechanical behavior of the different grasping suture techniques with different types of suture material can be provided.…”

Section: Discussionmentioning

confidence: 99%

“…The 50-N load was selected to simulate the tension on the sutures tied over a cortical bone bridge in ligament-reconstruction procedures [14], while the 200-N cyclic load was chosen because it locates in the ranges of force on the ACL during level walking (169 N) [5] and the load on the ulnar collateral ligament during throwing (290 N) [4]. A black line was drawn on the tendon at a point 5 cm from the distal end of the tendon, and black marks were made on both suture limbs where they extended from the tendon.…”

Section: Methodsmentioning

confidence: 99%

Do Needleless Knots have Similar Strength as the Krackow Suture? An In Vitro Porcine Tendon Study

Hong

Kuo

Yeh

et al. 2017

Clinical Orthopaedics &Amp; Related Research

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Background Numerous needleless techniques for tendon graft fixation that feature several advantages have been reported. However, there are few studies that have compared the holding strength between the needleless techniques (rolling hitch and modified rolling hitch) and traditional suture methods. Questions/purposes To compare the tendon graft-holding strength of the rolling hitch and modified rolling hitch with the Krackow stitch in an in vitro porcine biomechanical model. Methods Thirty fresh-frozen porcine flexor profundus tendons were randomly divided into three groups of 10 specimens. The experimental procedure was designed to assess elongation of the suture-tendon construct across the needleless tendon-grasping techniques and the Krackow stitch. All suture configurations were completed with a braided nonabsorbable suture. Each tendon was pretensioned to 100 N for three cycles, cyclically loaded from 50 to 200 N for 200 cycles, and then finally loaded to failure. Elongation, load to failure, and mode of failure were recorded for each specimen.

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The 45° and 60° of sagittal femoral tunnel placement in anterior cruciate ligament reconstruction provide similar knee stability

Cheng,

Yao,

Dimitriou

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeThe aim of the present study was to compare 45° and 60° of sagittal femoral tunnel angles in terms of anterior tibial translation (ATT), valgus angle and graft in situ force following anterior cruciate ligament reconstruction (ACLR).MethodsTen porcine knees were subjected to the following loading conditions: (1) 89 N anterior tibial load at 35° (full extension), 60° and 90° of knee flexion and (2) 5 N m valgus tibial moment at 35° and 45° of knee flexion. ATT and graft in situ force of the intact anterior cruciate ligament (ACL) and ACLR were collected using a robotic universal force/moment sensor (UFS) testing system for (1) ACL intact, (2) ACL‐deficient (ACLD) and (3) two different ACLR using different sagittal femoral tunnel angles (coronal 45°/sagittal 45° and coronal 45°/sagittal 60°).ResultsDuring the anterior tibial load, the femoral tunnel angle of ACLR knees at coronal 45°/sagittal 45° and 60° had significantly higher ATT than that of the ACL‐intact knees at 60° of knee flexion (p < 0.05). The femoral tunnel angle of ACLR knees at coronal 45°/sagittal 60° had significantly lower graft in situ force than that of the ACL‐intact knees at 60° and 90° of knee flexion (p < 0.05). During the valgus tibial moment, the femoral tunnel angle of ACLR knees at coronal 45°/sagittal 45° and 60° had significantly lower graft in situ force than that of the ACL‐intact knees at all knee flexions (p < 0.05).ConclusionsThe femoral tunnel angle of ACLR knees at coronal 45°/sagittal 45° provided similar ATT, valgus angle and graft in situ force to that of ACLR knees at coronal 45°/sagittal 60°. Therefore, both femoral tunnel angles could be used in ACLR, as the sagittal femoral tunnel angle does not appear to be relevant in post‐operative knee stability.Level of EvidenceNot applicable.

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Evaluation of biomechanical properties: are porcine flexor tendons and bovine extensor tendons eligible surrogates for human tendons in in vitro studies?

Abstract: Porcine flexor and bovine extensor tendons are eligible substitutes with similar stiffness and high failure loads compared with human cadaveric semitendinosus tendons in in vitro studies.

Cited by 75 publications

References 33 publications

The single-suture technique for anterior cruciate ligament graft preparation provides similar stability as a three-suture technique: a biomechanical in vitro study in a porcine model

The single-suture technique for anterior cruciate ligament graft preparation provides similar stability as a three-suture technique: a biomechanical in vitro study in a porcine model

Do Needleless Knots have Similar Strength as the Krackow Suture? An In Vitro Porcine Tendon Study

The 45° and 60° of sagittal femoral tunnel placement in anterior cruciate ligament reconstruction provide similar knee stability

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