The tensile strength of different methods of anterior cruciate ligament graft end stitches in an animal model

IF 1.6 4区医学 Q3 ORTHOPEDICS

Knee Pub Date : 2025-02-07 DOI:10.1016/j.knee.2025.01.012

Marcin Dembski , Patryk Kawa , Jakub Tarnawski , Marcin Ceynowa , Krzysztof Żerdzicki , Paweł Kłosowski

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引用次数: 0

Abstract

Background

There are several methods for stitching graft ends in anterior cruciate ligament reconstructive surgery. The tendon-suture construct should be able to withstand tensioning until the graft is stabilized with an implant.

Methods

In this biomechanical study, 40 porcine lower extremity tendons ends were stitched with No. 2 suture, secured to the grips of the Zwick-Roell testing machine and tested for load at failure and type of failure (tendon v/s suture thread). The applied force was linear, the results are given in Newtons (N) as a mean. The Mann-Whitney U test was used for statistical analysis. The following constructs were compared: a whipstitch of each tendon end individually with 3, 4, and 5 passes through the tendon, a whipstitch of both tendon ends folded together and a tendon end knot without stitching.

Results

All specimens survived the minimum tensile load of 80 N. The load at failure for whipstitch with 3,4 and 5 passes were 175 N, 211 N and 254 N respectively. The load at failure was greater for individual whipstitch than for both ends folded together (261 N v/s 152 N). The mean load at failure for braided graft was 209 N. The braided graft slips off the tendon before failure leading to uneven strength distribution during tensioning.

Conclusion

Increasing number of suture passes resulted in higher load at failure. Individual tendon ends whipstitched with 5 passes was the strongest construct. All of the investigated techniques are sufficient to withstand the suggested optimal graft tension of 80 N.

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来源期刊

Knee 医学-外科

CiteScore

3.80

自引率

5.30%

发文量

171

审稿时长

6 months

期刊介绍： The Knee is an international journal publishing studies on the clinical treatment and fundamental biomechanical characteristics of this joint. The aim of the journal is to provide a vehicle relevant to surgeons, biomedical engineers, imaging specialists, materials scientists, rehabilitation personnel and all those with an interest in the knee. The topics covered include, but are not limited to: • Anatomy, physiology, morphology and biochemistry; • Biomechanical studies; • Advances in the development of prosthetic, orthotic and augmentation devices; • Imaging and diagnostic techniques; • Pathology; • Trauma; • Surgery; • Rehabilitation.