In vitro testing protocols for the cruciate ligaments and ligament reconstructions

Abstract

The techniques that have been used to characterize the biomechanical behavior of the knee, cruciate ligaments, and cruciate ligament replacements differ, making comparisons between studies difficult or, at times, impossible. Therefore, it is important to standardize the testing protocols and techniques that describe the biomechanical behavior of the knee and cruciate ligaments. This will allow investigators to express opinions with respect to the interpretation of data, rather than based on differences between testing techniques. Standardized techniques are proposed to locate the origins of the tibial and femoral coordinate systems, and thus, allow comparisons of knee kinematics (e.g., displacements and rotations) between investigations. Standard techniques that can be used to measure the load-displacement behavior of the knee are described, and important considerations that should be appreciated with respect to preparing and testing of the joint are summarized. It is important to evaluate the single cycle load-to-failure characteristics and the cyclic loading response of an anterior cruciate ligament graft, and techniques to evaluate cruciate ligament graft fixation are proposed. The strengths of different models to characterize the biomechanical behavior of the knee are reviewed.

Tenodesis of the long head of biceps brachii: Cyclic testing of five methods of fixation in a porcine model

“…It has been shown that porcine bone is of consistent density, in contrast to the density of older human cadaveric specimens. 3 It may be argued that the porcine model may be more comparable to the good bone quality in young, active patients. In addition, several studies have shown that the porcine model is suitable for biomechanical testing of soft tissue-to-bone fixation.…”

Initial fixation strength of a hybrid technique for femoral ACL graft fixation

“…Cyclic loading seems to duplicate the physiological loading conditions more closely than single cycle failure tests [2]. We decided to use a protocol similar to that stated by Seil et al…”

Modified Prusik knot versus whipstitch technique for soft tissue fixation in anterior cruciate ligament reconstruction: a biomechanical analysis

“…A modified Prusik knot may be an alternative option for tibial fixation of soft tissue grafts in ACL reconstruction. The objective of this study was the investigation of the mechanical properties of the modified Prusik knot compared to the whipstitch technique in a load-to-failure and a cyclic loading test [2].…”