Mechanical assessment of tripled hamstring tendon graft when using suspensory fixation for cruciate ligament reconstruction

Abstract Background Tripling semitendinosus tendon for ACL graft preparation facilitates creation of longer and thicker grafts. Our objective was to evaluate the mechanical difference between tripled tendon grafts, prepared by three methods, by comparing with quadrupled tendon graft. Methods Bovine...

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Main Authors: I. Geethan, K. Santhosh Sahanand, P. R. Ashwin Vijay, David V. Rajan
Format: Article
Language:English
Published: Wiley 2018-11-01
Series:Journal of Experimental Orthopaedics
Subjects:
Online Access:http://link.springer.com/article/10.1186/s40634-018-0163-3
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author I. Geethan
K. Santhosh Sahanand
P. R. Ashwin Vijay
David V. Rajan
author_facet I. Geethan
K. Santhosh Sahanand
P. R. Ashwin Vijay
David V. Rajan
author_sort I. Geethan
collection DOAJ
description Abstract Background Tripling semitendinosus tendon for ACL graft preparation facilitates creation of longer and thicker grafts. Our objective was to evaluate the mechanical difference between tripled tendon grafts, prepared by three methods, by comparing with quadrupled tendon graft. Methods Bovine hind-foot hoof extensors were allocated to four groups. Group I had quadrupled graft construct. Tripled graft constructs were prepared by passing the tendon to the Endobutton CL loop and stitching the third strand to (i) the loop (in Group II) or (ii) to one strand(in Group III) or (iii)to loop and both tendon strands (in Group IV). The constructs were preloaded from 10 to 50 N at 0.1 Hz for 10 cycles, followed by 1000 cycles of sinusoidal loading between 50 and 250 N at a frequency of 0.5 Hz. The specimens were then subjected to load to failure test at the rate of 50 mm/min. Displacement with cyclic loading, load at failure and the mode of failure were noted. Results The load at failure was 957 ± 23.30 N (Mean ± Standard Deviation) in Group I, 590.8 ± 24.40 N in Group II, 682.6 ± 59.28 N in Group III and 963.4 ± 21.72 N in Group IV. The displacement with cyclic loading was 1.13 ± 0.11 mm in Group I, 4.908 ± 0.55 mm in Group II, 1.822 ± 0.55 mm in Group III and 1. 126 ± .018 mm in Group IV. There was no significant difference between the Groups I and IV with respect to the load at failure and displacement (p > 0.05). The values were significantly different in Group II and Group III (p < 0.01), when compared to groups I and IV. Conclusions Tripled grafts have mechanical properties equivalent to quadrupled grafts only when the three strands are sutured together. Caution may be warranted when using suspensory fixation device with tripled tendons and the third strand must be securely attached to the loop of fixation device and to the other two strands.
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spelling doaj.art-808b3279774a491eb2ab064001da0aa42024-04-03T08:57:05ZengWileyJournal of Experimental Orthopaedics2197-11532018-11-01511810.1186/s40634-018-0163-3Mechanical assessment of tripled hamstring tendon graft when using suspensory fixation for cruciate ligament reconstructionI. Geethan0K. Santhosh Sahanand1P. R. Ashwin Vijay2David V. Rajan3Arthroscopy Centre, Trichy, GastroCare HospitalOrtho One Orthopaedic Speciality CenterOrtho One Orthopaedic Speciality CenterOrtho One Orthopaedic Speciality CenterAbstract Background Tripling semitendinosus tendon for ACL graft preparation facilitates creation of longer and thicker grafts. Our objective was to evaluate the mechanical difference between tripled tendon grafts, prepared by three methods, by comparing with quadrupled tendon graft. Methods Bovine hind-foot hoof extensors were allocated to four groups. Group I had quadrupled graft construct. Tripled graft constructs were prepared by passing the tendon to the Endobutton CL loop and stitching the third strand to (i) the loop (in Group II) or (ii) to one strand(in Group III) or (iii)to loop and both tendon strands (in Group IV). The constructs were preloaded from 10 to 50 N at 0.1 Hz for 10 cycles, followed by 1000 cycles of sinusoidal loading between 50 and 250 N at a frequency of 0.5 Hz. The specimens were then subjected to load to failure test at the rate of 50 mm/min. Displacement with cyclic loading, load at failure and the mode of failure were noted. Results The load at failure was 957 ± 23.30 N (Mean ± Standard Deviation) in Group I, 590.8 ± 24.40 N in Group II, 682.6 ± 59.28 N in Group III and 963.4 ± 21.72 N in Group IV. The displacement with cyclic loading was 1.13 ± 0.11 mm in Group I, 4.908 ± 0.55 mm in Group II, 1.822 ± 0.55 mm in Group III and 1. 126 ± .018 mm in Group IV. There was no significant difference between the Groups I and IV with respect to the load at failure and displacement (p > 0.05). The values were significantly different in Group II and Group III (p < 0.01), when compared to groups I and IV. Conclusions Tripled grafts have mechanical properties equivalent to quadrupled grafts only when the three strands are sutured together. Caution may be warranted when using suspensory fixation device with tripled tendons and the third strand must be securely attached to the loop of fixation device and to the other two strands.http://link.springer.com/article/10.1186/s40634-018-0163-3Tripled hamstring tendonCruciate ligament reconstructionMechanical assessmentSuspensory fixation
spellingShingle I. Geethan
K. Santhosh Sahanand
P. R. Ashwin Vijay
David V. Rajan
Mechanical assessment of tripled hamstring tendon graft when using suspensory fixation for cruciate ligament reconstruction
Journal of Experimental Orthopaedics
Tripled hamstring tendon
Cruciate ligament reconstruction
Mechanical assessment
Suspensory fixation
title Mechanical assessment of tripled hamstring tendon graft when using suspensory fixation for cruciate ligament reconstruction
title_full Mechanical assessment of tripled hamstring tendon graft when using suspensory fixation for cruciate ligament reconstruction
title_fullStr Mechanical assessment of tripled hamstring tendon graft when using suspensory fixation for cruciate ligament reconstruction
title_full_unstemmed Mechanical assessment of tripled hamstring tendon graft when using suspensory fixation for cruciate ligament reconstruction
title_short Mechanical assessment of tripled hamstring tendon graft when using suspensory fixation for cruciate ligament reconstruction
title_sort mechanical assessment of tripled hamstring tendon graft when using suspensory fixation for cruciate ligament reconstruction
topic Tripled hamstring tendon
Cruciate ligament reconstruction
Mechanical assessment
Suspensory fixation
url http://link.springer.com/article/10.1186/s40634-018-0163-3
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AT prashwinvijay mechanicalassessmentoftripledhamstringtendongraftwhenusingsuspensoryfixationforcruciateligamentreconstruction
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