压缩减径对同种异体腓骨长肌移植物完整性的影响：生物力学分析

IF 1.5 Q3 ORTHOPEDICS

Journal of orthopaedics Pub Date : 2025-07-05 DOI:10.1016/j.jor.2025.06.036

Rafael Calvo Rodriguez , Waldo Gonzalez Duque , David Figueroa Poblete , Minerva Itriago , Rafael Calvo Mena , Jorge Isla Villanueva

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引用次数: 0

摘要

背景：关于前交叉韧带（ACL）重建手术所需的最小移植物直径有广泛的共识；当使用腘绳肌腱移植时，建议直径至少为8mm。然而，当大直径的移植物被压缩到小直径时会发生什么，以及这种改变如何影响移植物的生物力学特性，目前还不清楚。目的是确定压缩同种异体移植物在缩小其直径后是否能保持其生物力学强度，以及压缩技术是否可以被认为是小型患者（如妇女和儿童）的可行选择。我们的假设是，尽管直径减小，但压缩后的移植物可以保持与原始移植物相似的强度。方法采用30例腓骨长肌腱异体移植进行尸体生物力学病例对照研究。将移植物分为3组：0组（8 mm无压缩移植物）、1组（9 mm无压缩移植物）和2组（10 mm带移植物管，压缩至9 mm）。每个接枝都使用Zwick/Roell Z005拉伸试验机进行测试，在1 Hz下进行50至250 N的循环加载1000次，然后进行连续拉伸加载直至失效。记录每个接枝的最大破坏力（Fmax）。使用STATA v.18.5进行统计分析。结果组1 （9 mm未压缩接枝）平均最大破坏力为1902 N (SD: 432.12；95% ci)。组2（压缩接枝）平均Fmax为1608 N (SD: 233.12；95% CI)，两组间差异有统计学意义（p = 0.037）。0组（原生8 mm移植物）平均Fmax为1341 N (SD: 936.67；95% ci)。0组与2组间差异无统计学意义（p = 0.196）。结论与原9 mm移植物相比，压缩组具有较低的阻力。然而，与直径较小的移植物相比，强度没有明显差异。尽管如此，压缩的移植物比原生的8毫米移植物更能承受更高的负荷。

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Effect of diameter reduction by compression on peroneus longus allograft integrity: A biomechanical analysis

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.

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来源期刊

Journal of orthopaedics ORTHOPEDICS-

CiteScore

3.50

自引率

6.70%

发文量

202

审稿时长

56 days

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.