Rafael Calvo Rodriguez , Waldo Gonzalez Duque , David Figueroa Poblete , Minerva Itriago , Rafael Calvo Mena , Jorge Isla Villanueva
{"title":"Effect of diameter reduction by compression on peroneus longus allograft integrity: A biomechanical analysis","authors":"Rafael Calvo Rodriguez , Waldo Gonzalez Duque , David Figueroa Poblete , Minerva Itriago , Rafael Calvo Mena , Jorge Isla Villanueva","doi":"10.1016/j.jor.2025.06.036","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>There is broad consensus regarding the minimum required graft diameter in anterior cruciate ligament (ACL) reconstruction surgery; a diameter of at least 8 mm is recommended when using hamstring tendon grafts. However, it remains unclear what happens when a larger-diameter graft is compressed to a smaller diameter, and how this alteration may affect the biomechanical properties of the graft. The objectives is determine whether the biomechanical strength of compressed allografts is preserved after reducing their diameter, and whether compression techniques could be considered a viable option for smaller patients such as women and children. Our hypothesis is that a compressed graft may retain similar strength to the original, despite having a reduced diameter.</div></div><div><h3>Methods</h3><div>This was a cadaveric biomechanical case-control study using 30 peroneus longus (PL) tendon allografts. The grafts were divided into three groups: Group 0 (8 mm uncompressed grafts), Group 1 (9 mm uncompressed grafts), and Group 2 (10 mm with a graft tube, compression to 9 mm). Each graft was tested using a Zwick/Roell Z005 tensile testing machine, undergoing cyclic loading between 50 and 250 N at 1 Hz for 1000 cycles, followed by continuous tensile loading to failure. The maximum failure force (Fmax) was recorded for each graft. Statistical analyses were performed using STATA v.18.5.</div></div><div><h3>Results</h3><div>Group 1 (9 mm uncompressed grafts) showed a mean maximum failure force of 1902 N (SD: 432.12; 95 % CI). Group 2 (compressed grafts) showed a mean Fmax of 1608 N (SD: 233.12; 95 % CI), with a statistically significant difference between the two groups (p = 0.037). Group 0 (native 8 mm grafts) showed a mean Fmax of 1341 N (SD: 936.67; 95 % CI). No statistically significant difference was found between Group 0 and Group 2 (p = 0.196).</div></div><div><h3>Conclusions</h3><div>The results indicate that the compressed group had lower resistance compared to the original 9 mm grafts. However, when compared to the smaller-diameter grafts, no significant difference in strength was observed. Nonetheless, the compressed grafts showed a tendency to withstand higher loads than the native 8 mm grafts.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"66 ","pages":"Pages 346-350"},"PeriodicalIF":1.5000,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of orthopaedics","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0972978X25002600","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
Abstract
Background
There is broad consensus regarding the minimum required graft diameter in anterior cruciate ligament (ACL) reconstruction surgery; a diameter of at least 8 mm is recommended when using hamstring tendon grafts. However, it remains unclear what happens when a larger-diameter graft is compressed to a smaller diameter, and how this alteration may affect the biomechanical properties of the graft. The objectives is determine whether the biomechanical strength of compressed allografts is preserved after reducing their diameter, and whether compression techniques could be considered a viable option for smaller patients such as women and children. Our hypothesis is that a compressed graft may retain similar strength to the original, despite having a reduced diameter.
Methods
This was a cadaveric biomechanical case-control study using 30 peroneus longus (PL) tendon allografts. The grafts were divided into three groups: Group 0 (8 mm uncompressed grafts), Group 1 (9 mm uncompressed grafts), and Group 2 (10 mm with a graft tube, compression to 9 mm). Each graft was tested using a Zwick/Roell Z005 tensile testing machine, undergoing cyclic loading between 50 and 250 N at 1 Hz for 1000 cycles, followed by continuous tensile loading to failure. The maximum failure force (Fmax) was recorded for each graft. Statistical analyses were performed using STATA v.18.5.
Results
Group 1 (9 mm uncompressed grafts) showed a mean maximum failure force of 1902 N (SD: 432.12; 95 % CI). Group 2 (compressed grafts) showed a mean Fmax of 1608 N (SD: 233.12; 95 % CI), with a statistically significant difference between the two groups (p = 0.037). Group 0 (native 8 mm grafts) showed a mean Fmax of 1341 N (SD: 936.67; 95 % CI). No statistically significant difference was found between Group 0 and Group 2 (p = 0.196).
Conclusions
The results indicate that the compressed group had lower resistance compared to the original 9 mm grafts. However, when compared to the smaller-diameter grafts, no significant difference in strength was observed. Nonetheless, the compressed grafts showed a tendency to withstand higher loads than the native 8 mm grafts.
期刊介绍:
Journal of Orthopaedics aims to be a leading journal in orthopaedics and contribute towards the improvement of quality of orthopedic health care. The journal publishes original research work and review articles related to different aspects of orthopaedics including Arthroplasty, Arthroscopy, Sports Medicine, Trauma, Spine and Spinal deformities, Pediatric orthopaedics, limb reconstruction procedures, hand surgery, and orthopaedic oncology. It also publishes articles on continuing education, health-related information, case reports and letters to the editor. It is requested to note that the journal has an international readership and all submissions should be aimed at specifying something about the setting in which the work was conducted. Authors must also provide any specific reasons for the research and also provide an elaborate description of the results.