The effect of sterilization and storage on the viscoelastic properties of human tendon allografts

Gökler, Daniella Judit; Faragó, Dénes; Szebényi, Gábor; Kiss, Rita M.; Pap, Károly

doi:10.1016/j.jbiomech.2021.110697

Cited by 8 publications

(3 citation statements)

References 32 publications

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“…The systematic review aimed at creating a comprehensive catalogue of existing clamps used in the determination of biomechanical properties. These studies evaluated what kind of impact the type of clamp had on the measurement [ 35 – 39 , 41 – 46 , 48 – 53 , 55 – 57 , 59 – 66 , 68 – 82 , 84 – 87 , 89 , 90 , 92 – 96 , 98 , 99 , 101 – 104 , 106 – 111 , 113 – 117 ].A variety of clamps for use during the endurance test of tendons were categorized according to the temperature used during the measurement. The clamps are divided into three groups: room temperature clamps [ 61 , 106 , 107 ] [ 35 , 37 – 39 , 41 , 44 – 46 , 48 , 49 , 51 – 53 , 55 – 57 , 59 , 62 , 64 , 70 , 72 , 75 , 77 – 80 , 84 , 85 , 87 , 89 , 90 , 92 – 94 , 96 , 98 , 99 , 101 – 103 , 109 – 111 , ...…”

Section: Resultsmentioning

confidence: 99%

Categorize the existing clamps used for tensile test of human graft– a systematic review

Faragó

Kozma

Kiss

2022

BMC Musculoskelet Disord

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Background The use of tendon allografts for orthopedic repair has gained wide acceptance in recent years, most notably in anterior cruciate tendon reconstruction. Multiple studies support the use of tendon allografts and the benefits of its use are well accepted and understood. One of the important criteria of the use of tendon allografts is statistically similar histological and biomechanical properties to autographs. The aim of this systematic literature review is to investigate and categorize existing clamps used in the determination of the biomechanical properties of tendons such as maximum load, maximum strength, modulus of elasticity, ultimate strain, and stiffness. A variety of clamps for use during the endurance test of tendons were categorized according to the temperature used during the measurement. The clamps are divided into three groups: room temperature, cooled and heated clamps. The second goal of our review is to overview of clamps on the following aspects: name of clamp, author and date, type of clamps, type of endurance test (static or dynamic), type preloading (dynamic or static), type of tendon and measured and calculated parameters, and summarize in Table 3, as a comprehensive catalogue. Methods This systematic review was carried out in keeping with the PRISMA 2020 E&E and the PRISMA-S guidelines and checklists. A search was conducted for publications dating between 1991 and February 28th 2022 through three electronic databases (Web of Science, Scopus, and PubMed). We used Critical Appraisal Skills Program checklist to check the quality of included articles. Results The database search and additional sources resulted in 1725 records. 1635 records eliminated during the screening for various reasons (case report, other languages, book chapter, unavailable text/conference abstract, unrelated topic). The number of articles used in the final synthesis was 90. A variety of clamps for use during the endurance test of tendons were identified and categorized according to the temperature used during the measurement. Based on this, the clamps are divided into three groups: room temperature, cooled or heated clamps. Conclusions On the basis of the systematic literature review, mechanical parameters determined by usage with cooled clamps proved to be more reliable than with those at room temperature and with heated clamps. The collected information from the articles included name of clamp, author and date, type of clamps, type of endurance test (static or dynamic), type preloading (dynamic or static), type of tendon and measured and calculated parameters given in Table 3. summarized. The main advantage of the cooled clamps is that there is no limit to the type and length of the tendon. This study provides an overview of clamps and does not represent the modernity of any method.

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Section: Resultsmentioning

confidence: 99%

Categorize the existing clamps used for tensile test of human graft– a systematic review

Faragó

Kozma

Kiss

2022

BMC Musculoskelet Disord

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“…Studies have demonstrated that, 30 minutes after xation, the initial tension of the graft can be reduced by 70%, and the tibial xation screw xation releases the extra-articular tension, and the decrease in ligament tension is even greater [15,[23][24][25][26]. Therefore, proper initial tension of the graft during ACL reconstruction is crucial.…”

Section: Discussionmentioning

confidence: 99%

Development and application of the online initial graft tension measurement system for anterior cruciate ligament reconstruction

Chen

Zhao

Liao

et al. 2023

Preprint

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The initial graft tension during ACL reconstruction is an essential mechanical parameter. We established a viscoelastic lateral mechanical measurement model. Based on this model, we designed the online measurement system for the initial graft tension during ACL reconstruction. 22 patients with chronic ACL deficiency were treated by single-bundle ACL reconstruction. 12 patients underwent single-bundle ACL reconstruction (group 1), whereas 10 underwent single-bundle ACL reconstruction using the online tension measurement system (group 2). All patients were followed up with the Lysholm score and International Knee Documentation Committee (IKDC) score to evaluate knee joint function. The Lysholm scores and the IKDC scores of the two groups were significantly higher at 1 month and 3 months after the operation with a significant difference, and the Lysholm scores and the IKDC scores of the instrument group (group 2) was significantly higher than those of the control group with significant difference (group 1). In the same ACL single-bundle reconstruction, the application of the online initial graft tension measurement system can provide quantification for the initial graft tension of ACL, improving the current situation in which only experience can be used to estimate the initial graft tension.

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“…However, there are limited animal and human studies on the mechanical effects of prolonged storage for tendons specifically. Only two reports of storage up to 6 months 4,14 ; two up to 9 months 15,16 ; two up to 360 days 17,18 ; and only one study has directly compared lower (−80°C) versus higher (−20°C) storage temperatures at a single extended time point (9 months). 15 The scarcity of evidence indicates a gap in our knowledge of the temporal effects of tendon storage at lower and higher ranges of temperatures, and whether changes are progressive, regressive or stabilize over time.…”

Section: Introductionmentioning

confidence: 99%

Tendon biomechanical properties are altered by storage duration but not freeze‐thaw temperatures or cycles

Blaker,

Ashton,

Hartnell

et al. 2024

Journal Orthopaedic Research

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Tendon allograft and xenograft processing often involves one or more steps of freezing and thawing. As failure strength is an important graft consideration, this study aimed to evaluate effects on failure properties when varying freeze‐thaw conditions. Kangaroo tendons, a potential xenograft source, were used to evaluate changes in ultimate tensile strength (UTS), failure strain and elastic modulus after exposure to different freezer‐storage temperatures (−20°C vs. −80°C), storage durations (1, 3, 6, 9, or 12 months), number of freeze‐thaw cycles (1, 2, 3, 4, 5, or 10), or freeze‐thaw temperature ranges (including freezing in liquid nitrogen to thawing at 37°C). Tendons stored for 6 or more months had significantly increased UTS and elastic modulus compared with 1 or 3 months of storage. This increase occurred irrespective of the freezing temperature (−20°C vs. −80°C) or the number of freeze‐thaw cycles (1 vs. 10). In contrast, UTS, failure strain and the elastic modulus were no different between storage temperatures, number of freeze‐thaw cycles and multiple freeze‐thaw cycles across a range of freeze and thaw temperatures. Common freeze‐thaw protocols did not negatively affect failure properties, providing flexibility for graft testing, storage, transportation and decellularisation procedures. However, the change in properties with the overall storage duration has implications for assessing the consistent performance of grafts stored for short versus extended periods of time (<6 months vs. >6 months), and the interpretation of data obtained from tissues of varying or unknown storage durations.

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The effect of sterilization and storage on the viscoelastic properties of human tendon allografts

Cited by 8 publications

References 32 publications

Categorize the existing clamps used for tensile test of human graft– a systematic review

Categorize the existing clamps used for tensile test of human graft– a systematic review

Development and application of the online initial graft tension measurement system for anterior cruciate ligament reconstruction

Tendon biomechanical properties are altered by storage duration but not freeze‐thaw temperatures or cycles

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