How Variable Are Achilles Allografts Used for Anterior Cruciate Ligament Reconstruction? A Biomechanical Study

Weber, Alexander E.; Mayer, Erik N.; Nathani, Amit; Chen, Dan X.; Rodeo, Scott A.; Bedi, Asheesh

doi:10.1177/0363546518768780

Cited by 12 publications

(12 citation statements)

References 53 publications

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“…In a biomechanical study for anterior cruciate ligament reconstruction, achilles tendon allograft elongation averaged by 1.4% +/-1.6% after cyclic testing with 1000 submaximal cycles in the physiological loading between 50 N and 250 N was shown. Based on an average tendon length of 7cm, there would be only an elongation of 0.98mm and may be even smaller in elbow due to the lower cycling loadings [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Indirect markers for length adjustment in distal biceps tendon allograft reconstruction

et al. 2021

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Chronic musculotendinous retraction, shortening and fibrosis after distal biceps tendon tears makes a primary reconstruction often difficult or even impossible. Interposition reconstruction with allograft provides a solution, however there is no consensus about appropriate intraoperative graft length adjustment. Therefore, the purpose of this study was to find a practical reference value for distal biceps tendon length adjustment. Three-dimensional surface models of healthy distal biceps tendons were created based on 85 MRI scans. The tendon length was measured from the myotendinous junction to the insertion on the bicipital tuberosity. Inter-epicondylar distance (IED) and radial head diameter (RHD) were measured on antero-posterior radiographs as a surrogate for patient size. Correlations between the tendon length and IED, RHD and patient’s height (PH) were calculated. Mean length of the external part of the distal biceps tendon was 69mm (female 64mm, male 71mm). The tendon length in mm was on average 1.1 times of the IED (mm), 3 times of the RHD (mm) and 0.4 times of PH (cm). Herewith, the tendon length could be predicted within a narrow range of +/-1cm in 84% by using IED, 82% by using RHD and 80% by using PH. Intra- and inter-reader reliabililty of IED and RHD was excellent (R2 = 0.938–0.981). The distal biceps tendon length can be best predicted within 1cm with an accuracy of 82–84% using the IED and RHD with an excellent intra- and inter-reader reliability.

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Section: Discussionmentioning

confidence: 99%

Indirect markers for length adjustment in distal biceps tendon allograft reconstruction

et al. 2021

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“…2 and 3.]. Viruses can be tested for in labs prior to a transplant [28,[31][32][33][34][35][36][37][38][39][40][41].…”

Section: Discussionmentioning

confidence: 99%

“…The values between 14.6-40 kGy radiation dose were examined. In two cases [33,36], the gamma radiation improved the failure load and Young's modulus of elasticity of the tendons.…”

Section: Non-sterilized Tendon (Fresh/control Tendon)mentioning

confidence: 98%

“…Average result of failure load and Young's modulus of elasticity of non-sterilized and non-frozen tendons[8, 27-30, 43-45, 50, 52] Gamma radiation is one of the most common sterilization methods. This sterilization method is processed by ten articles[8,28,[31][32][33][34][35][36][37][38][39][40][41][44][45][46]48,53; Table 3.]. During radiation, two doses are distinguished, the low dose (bacterial dose) of 15-26 kGy and the high dose (viricidal dose) of 30-45 kGy[38,41].…”

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confidence: 99%

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Different sterilization methods used for human tendons – A systematic review

Faragó

Kozma

Kiss

2021

Preprint

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BackgroundIt is important to know the biomechanical properties of an allograft. This is because when looking to do a transplant of a tendon, the tendon must have very similar biomechanical properties to the original tendon. To use tendon allografts, it is critical to properly sterilize the tendon before implantation. In past decades, several sterilization procedures have been used. This study aimed to systematically evaluate the existing literature to compare the values of failure load/ultimate strength and Young’s modulus of elasticity of different sterilization methods on commonly used tendon allografts. Five major scientific literature databases (Web of Science, Science Direct, Scopus, PLOS ONE, Hindawi) and additional sources were used.ResultsStudies used had to show a particular sterilization method. Studies were identified to meet the following inclusion criteria: is a controlled laboratory study, gamma irradiation (dose reported), and other sterilization methods. Search for publications dated between 1991 and March 31st, 2020. A total of 54 articles have been included. Data collected from the full-text assessment included: a) author and date, b) type of tendon, c) type of sterilization, d) sterilization dose, and g) measured and calculated parameters. Different types of sterilization methods used before tendon durability testing have been identified and categorized.ConclusionsIdentified sterilization methods (gamma irradiation, dry ice, supercritical carbon dioxide (SCCO2), BioCleanse, Electron Beam) are offered as a catalog of potential methods.As a result of the broadness of the present research, it provides an overview of sterilization methods. It does not stand for the state-of-the-art of any single process.

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“…Furthermore, Achilles tendon allografts have been successfully used in tendon and ligamentous reconstructions throughout the body, including anterior cruciate ligament, posterior cruciate ligament reconstruction, and distal biceps repair. [14][15][16]21,22 Unlike dermal patches, Achilles tendon allografts provide the opportunity for graft incorporation.…”

Section: Graft Preparationmentioning

confidence: 99%

Superior Capsular Reconstruction with Achilles Tendon Allograft

Mease

Moontasri

Kurowicki

et al. 2020

Arthroscopy Techniques

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Superior capsular reconstruction (SCR) has become an increasingly popular choice in the treatment of massive, irreparable rotator cuff tears, pseudoparalysis, and in cases in which revision of previous rotator cuff repair is indicated. The SCR procedure is intended to restore the superior stabilizing forces of a deficient rotator cuff. This technique is accomplished by substituting an autograft or allograft between the superior glenoid and the greater tuberosity of the humerus, thus keeping the humeral head centered in the glenoid during shoulder forward flexion and abduction. Since its advent, numerous techniques have been described for this procedure. A fascia lata autograft was initially described; however, many surgeons in the United States have advocated for the use of a humeral dermal allograft. Yet, biomechanical studies have demonstrated elongation and thinning of this material. Thus, the Achilles tendon allograft may be an attractive choice for SCR, given its previous success with ligamentous and tendinous reconstructions. In this article, we present our technique of SCR using an Achilles tendon allograft.

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How Variable Are Achilles Allografts Used for Anterior Cruciate Ligament Reconstruction? A Biomechanical Study

Cited by 12 publications

References 53 publications

Indirect markers for length adjustment in distal biceps tendon allograft reconstruction

Indirect markers for length adjustment in distal biceps tendon allograft reconstruction

Different sterilization methods used for human tendons – A systematic review

Superior Capsular Reconstruction with Achilles Tendon Allograft

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