The single-suture technique for anterior cruciate ligament graft preparation provides similar stability as a three-suture technique: a biomechanical in vitro study in a porcine model.

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Tytuł:: The single-suture technique for anterior cruciate ligament graft preparation provides similar stability as a three-suture technique: a biomechanical in vitro study in a porcine model.
Autorzy:: Theopold J; Department of Orthopedic, Trauma and Plastic Surgery, University of Leipzig, Liebigstraße 20, 04103, Leipzig, Germany. .
Schleifenbaum S; ZESBO, Zentrum Zur Erforschung Der Stütz- Und Bewegungsorgane, Semmelweisstrasse 14, 04103, Leipzig, Germany.
Georgi A; Department of Orthopedic, Trauma and Plastic Surgery, University of Leipzig, Liebigstraße 20, 04103, Leipzig, Germany.
Schmidt M; ZESBO, Zentrum Zur Erforschung Der Stütz- Und Bewegungsorgane, Semmelweisstrasse 14, 04103, Leipzig, Germany.
Henkelmann R; Department of Orthopedic, Trauma and Plastic Surgery, University of Leipzig, Liebigstraße 20, 04103, Leipzig, Germany.
Osterhoff G; Department of Orthopedic, Trauma and Plastic Surgery, University of Leipzig, Liebigstraße 20, 04103, Leipzig, Germany.
Hepp P; Department of Orthopedic, Trauma and Plastic Surgery, University of Leipzig, Liebigstraße 20, 04103, Leipzig, Germany.
Źródło:: Archives of orthopaedic and trauma surgery [Arch Orthop Trauma Surg] 2020 Apr; Vol. 140 (4), pp. 511-516. Date of Electronic Publication: 2020 Jan 24.
Typ publikacji:: Journal Article
Język:: English
Imprint Name(s):: Publication: Berlin : Springer Verlag
Original Publication: Berlin : Springer International, c1989-
MeSH Terms:: Suture Techniques*
Anterior Cruciate Ligament/*surgery
Anterior Cruciate Ligament Reconstruction/*methods
Tendons/*transplantation
Tibia/*surgery
Animals ; Swine
References:: Arch Orthop Trauma Surg. 2019 Jan;139(1):73-78. (PMID: 30039308)
Arthroscopy. 2011 Jun;27(6):834-8. (PMID: 21624678)
Z Orthop Unfall. 2017 Jun;155(3):340-343. (PMID: 28423436)
Arthroscopy. 2010 Aug;26(8):1105-10. (PMID: 20678709)
Am J Sports Med. 2004 Apr-May;32(3):635-40. (PMID: 15090378)
Arthroscopy. 2010 Dec;26(12):1662-6. (PMID: 20926231)
Arthrosc Tech. 2012 Aug 31;1(2):e165-8. (PMID: 23766990)
Arthroscopy. 2008 May;24(5):599-603. (PMID: 18442694)
Arthroscopy. 2014 Dec;30(12):1609-15. (PMID: 25174535)
Foot Ankle Int. 2012 Sep;33(9):717-21. (PMID: 22995257)
Arch Orthop Trauma Surg. 2018 Jan;138(1):139-145. (PMID: 29134318)
Am J Sports Med. 2012 Jul;40(7):1641-5. (PMID: 22691458)
Arthrosc Tech. 2014 May 12;3(3):e321-4. (PMID: 25126495)
Knee Surg Sports Traumatol Arthrosc. 2018 Dec;26(12):3690-3698. (PMID: 29687166)
Arthroscopy. 2009 Feb;25(2):200-7. (PMID: 19171281)
Musculoskelet Surg. 2014 Dec;98(3):179-87. (PMID: 25269758)
Am J Sports Med. 2015 Jun;43(6):1380-5. (PMID: 25767269)
Arthroscopy. 2007 Mar;23(3):326.e1-3. (PMID: 17349483)
Knee Surg Sports Traumatol Arthrosc. 2016 Sep;24(9):2983-2989. (PMID: 25894752)
Int Orthop. 2013 Feb;37(2):279-84. (PMID: 23307016)
J Exp Orthop. 2018 Jun 15;5(1):20. (PMID: 29904897)
Med Eng Phys. 2012 Nov;34(9):1221-7. (PMID: 22297087)
Arch Orthop Trauma Surg. 2016 Oct;136(10):1465-71. (PMID: 27475640)
Open Access J Sports Med. 2016 Feb 24;7:21-32. (PMID: 26955296)
Knee Surg Sports Traumatol Arthrosc. 2018 Feb;26(2):634-647. (PMID: 28939947)
Arch Orthop Trauma Surg. 2015 Dec;135(12):1733-41. (PMID: 26391988)
Arch Orthop Trauma Surg. 2016 Nov;136(11):1595-1600. (PMID: 27498103)
Arch Bone Jt Surg. 2015 Oct;3(4):220-40. (PMID: 26550585)
Contributed Indexing:: Keywords: ACL reconstruction; Anterior cruciate ligament; Arthroscopy; Biomechanics; Hamstring graft; Patient safety
Entry Date(s):: Date Created: 20200126 Date Completed: 20200908 Latest Revision: 20210110
Update Code:: 20240104
PubMed Central ID:: PMC7109177
DOI:: 10.1007/s00402-020-03350-5
PMID:: 31980876
: Czasopismo naukowe

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Purpose: Numerous techniques have been described for the tibial-sided graft preparation in anterior cruciate ligament (ACL) reconstruction. The use of less suture material for graft preparation is thought to improve ingrowth and to reduce the risk for infection. At the same time, the suture construct should be strong enough to resist the surgeon's pull during tensioning of the transplant.
Methods: In total, 39 fresh-frozen procine deep flexor tendons were used and prepared as four-strand grafts. In the three-suture group (n = 19), graft preparation was performed using three tibial-sided sutures, with each tendon end sutured separately. In the one-suture group (n = 20), a modified graft preparation using only one tibial-sided suture was applied. Each sample underwent load-to-failure testing (N max ) after cyclic pre-loading. To estimate intraoperative tension forces acting on the tibial-sided suture constructs, the maximal tension force of 26 volunteers on such a construct was measured using a load cell.
Results: The biomechanical testing of the two different suture constructs showed a significantly higher load-to-failure for the three-suture group (711 N ± 91 N) compared to the one-suture group (347 N ± 24 N) (p = 0.0001). In both groups, the mode of failure was a tear of the suture in all samples. A failure of the suture-tendon interface was not observed in any case. The median maximal tension force on the construct applied by the 26 volunteers was 134 N (range 73-182 N).
Conclusion: The presented single-suture tendon graft preparation resisted to smaller failure loads than the conventional three-suture technique. However, no failures in the suture-tendon interface were seen and the failure loads observed were far beyond the tension forces that can be expected intraoperatively. Hence, the single-suture graft preparation technique may be a valuable alternative to the conventional technique.

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