nach oben

Erschienen in:

05.11.2015 | Original Paper

Can the gracilis replace the anterior cruciate ligament in the knee? A biomechanical study

verfasst von: Etienne Cavaignac, Regis Pailhé, Nicolas Reina, Jérôme Murgier, Jean Michel Laffosse, Philippe Chiron, Pascal Swider

Erschienen in: International Orthopaedics | Ausgabe 8/2016

Einloggen, um Zugang zu erhalten

Abstract

Purpose

The purpose of this study was to determine whether a four-strand gracilis-only construct possesses the biomechanical properties needed to act as an anterior cruciate ligament (ACL) reconstruction graft.

Methods

This was a pilot study with 32 cadaver specimens. The biomechanical properties of three types of grafts were determined using validated tensile testing methods: patellar tendon (BTB), both hamstring tendons together (GST4) and gracilis alone (G4).

Results

The maximum load at failure of the G4 was 416.4 N (±187.7). The GST4 and BTB had a maximum load at failure of 473.5 N (±176.9) and 413.3 N (±120.4), respectively. The three groups had similar mean maximum load and stiffness values. The patellar tendon had significantly less elongation at failure than the other two graft types.

Conclusions

The biomechanical properties of a four-strand gracilis construct are comparable to the ones of standard grafts. This type of graft would be useful in the reconstruction of the anteromedial bundle in patients with partial ACL ruptures.

Bonamo JJ, Krinick RM, Sporn AA (1984) Rupture of the patellar ligament after use of its central third for anterior cruciate reconstruction. A report of two cases. J Bone Joint Surg Am 66(8):1294–1297PubMed

Goyal S, Matias N, Pandey V, Acharya K (2015) Are pre-operative anthropometric parameters helpful in predicting length and thickness of quadrupled hamstring graft for ACL reconstruction in adults? A prospective study and literature review. Int Orthop. doi:10.1007/s00264-015-2818-3 PubMed

Stevanovic V, Blagojevic Z, Petkovic A, Glisic M, Sopta J, Nikolic V, Milisavljevic M (2013) Semitendinosus tendon regeneration after anterior cruciate ligament reconstruction: can we use it twice? Int Orthop 37(12):2475–2481CrossRefPubMedPubMedCentral

Nakamura N, Horibe S, Sasaki S et al (2002) Evaluation of active knee flexion and hamstring strength after anterior cruciate ligament reconstruction using hamstring tendons. Arthroscopy 18(6):598–602CrossRefPubMed

Pailhe R, Cavaignac E, Murgier J et al (2015) Biomechanical study of ACL reconstruction grafts. J Orthop Res. doi:10.1002/jor.22889 PubMed

Shelburne KB, Torry MR, Pandy MG (2005) Effect of muscle compensation on knee instability during ACL-deficient gait. Med Sci Sports Exerc 37(4):642–648CrossRefPubMed

Cavaignac E, Pailhe R, Murgier J et al (2014) Can the gracilis be used to replace the anterior cruciate ligament in the knee? A cadaver study. Knee 21(6):1014-1017. doi:10.1016/j.knee.2014.07.010 CrossRefPubMed

Zamarra G, Fisher MB, Woo SL, Cerulli G (2010) Biomechanical evaluation of using one hamstrings tendon for ACL reconstruction: a human cadaveric study. Knee Surg Sports Traumatol Arthrosc 18(1):11–19. doi:10.1007/s00167-009-0911-0 CrossRefPubMed

Handl M, Drzik M, Cerulli G et al (2007) Reconstruction of the anterior cruciate ligament: dynamic strain evaluation of the graft. Knee Surg Sports Traumatol Arthrosc 15(3):233–241. doi:10.1007/s00167-006-0175-x CrossRefPubMed

10.

Sajovic M, Vengust V, Komadina R et al (2006) A prospective, randomized comparison of semitendinosus and gracilis tendon versus patellar tendon autografts for anterior cruciate ligament reconstruction: five-year follow-up. Am J Sports Med 34(12):1933–1940. doi:10.1177/0363546506290726 CrossRefPubMed

11.

Neyret P, Demey G (2012) Reconstruction du ligament croisé antérieur: technique chirurgicale. In: Traité de chirurgie du genou. Elsevier Masson, Paris, pp 41-64

12.

Huang H, Zhang J, Sun K et al (2011) Effects of repetitive multiple freeze-thaw cycles on the biomechanical properties of human flexor digitorum superficialis and flexor pollicis longus tendons. Clin Biomech (Bristol, Avon) 26(4):419–423. doi:10.1016/j.clinbiomech.2010.12.006 CrossRef

13.

Shi D, Wang D, Wang C, Liu A (2012) A novel, inexpensive and easy to use tendon clamp for in vitro biomechanical testing. Med Eng Phys 34(4):516–520. doi:10.1016/j.medengphy.2011.11.019 CrossRefPubMed

14.

Yanke AB, Bell R, Lee AS et al (2013) Central-third bone-patellar tendon-bone allografts demonstrate superior biomechanical failure characteristics compared with hemi-patellar tendon grafts. Am J Sports Med 41(11):2521–2526. doi:10.1177/0363546513501780 CrossRefPubMed

15.

Hertzog MA (2008) Considerations in determining sample size for pilot studies. Res Nurs Health 31(2):180–191. doi:10.1002/nur.20247 CrossRefPubMed

16.

Pujol N, Queinnec S, Boisrenoult P, Maqdes A, Beaufils P (2013) Anatomy of the anterior cruciate ligament related to hamstring tendon grafts. A cadaveric study. Knee 20(6):511–514. doi:10.1016/j.knee.2012.10.006 CrossRefPubMed

17.

Marzo JM, Bowen MK, Warren RF et al (1992) Intraarticular fibrous nodule as a cause of loss of extension following anterior cruciate ligament reconstruction. Arthroscopy 8(1):10–18CrossRefPubMed

18.

Buda R, Ruffilli A, Parma A et al (2013) Partial ACL tears: anatomic reconstruction versus nonanatomic augmentation surgery. Orthopedics 36(9):e1108–e1113. doi:10.3928/01477447-20130821-10 CrossRefPubMed

19.

Sonnery-Cottet B, Panisset JC, Colombet P et al (2012) Partial ACL reconstruction with preservation of the posterolateral bundle. Orthop Traumatol Surg Res 98(8 Suppl):S165–S170. doi:10.1016/j.otsr.2012.10.001 CrossRefPubMed

20.

Pujol N, Colombet P, Potel JF et al (2012) Anterior cruciate ligament reconstruction in partial tear: selective anteromedial bundle reconstruction conserving the posterolateral remnant versus single-bundle anatomic ACL reconstruction: preliminary 1-year results of a prospective randomized study. Orthop Traumatol Surg Res 98(8 Suppl):S171–S177. doi:10.1016/j.otsr.2012.09.007 CrossRefPubMed

21.

Moon DK, Woo SL, Takakura Y et al (2006) The effects of refreezing on the viscoelastic and tensile properties of ligaments. J Biomech 39(6):1153–1157. doi:10.1016/j.jbiomech.2005.02.012 CrossRefPubMed

22.

Noyes FR, DeLucas JL, Torvik PJ (1974) Biomechanics of anterior cruciate ligament failure: an analysis of strain-rate sensitivity and mechanisms of failure in primates. J Bone Joint Surg Am 56(2):236–253PubMed

23.

Butler DL, Grood ES, Noyes FR et al (1984) Effects of structure and strain measurement technique on the material properties of young human tendons and fascia. J Biomech 17(8):579–596CrossRefPubMed

24.

Cheung JT, Zhang M (2006) A serrated jaw clamp for tendon gripping. Med Eng Phys 28(4):379–382. doi:10.1016/j.medengphy.2005.07.010 CrossRefPubMed

25.

Pap K, Hangody G, Szebenyi G, Rita K, Panics G, Hangody L (2014) An easy way to fix tendon allografts into a loading—machine for biomechanical testing. Paper presented at the 16th ESSKA Congress, Amsterdam, 14-17 May

26.

van Dommelen JA, Jolandan MM, Ivarsson BJ et al (2006) Nonlinear viscoelastic behavior of human knee ligaments subjected to complex loading histories. Ann Biomed Eng 34(6):1008–1018. doi:10.1007/s10439-006-9100-1 CrossRefPubMed

27.

Noyes FR, Butler DL, Grood ES et al (1984) Biomechanical analysis of human ligament grafts used in knee-ligament repairs and reconstructions. J Bone Joint Surg Am 66(3):344–352PubMed

28.

Chandrashekar N, Mansouri H, Slauterbeck J et al (2006) Sex-based differences in the tensile properties of the human anterior cruciate ligament. J Biomech 39(16):2943–2950CrossRefPubMed

29.

Elias JJ, Rai SP, Ciccone WJ et al (2008) In vitro comparison of tension and stiffness between hamstring tendon and patella tendon grafts. J Orthop Res 26(11):1506–1511CrossRefPubMed

30.

Harner CD, Baek GH, Vogrin TM et al (1999) Quantitative analysis of human cruciate ligament insertions. Arthroscopy 15(7):741–749CrossRefPubMed

31.

Hashemi J, Mansouri H, Chandrashekar N et al (2011) Age, sex, body anthropometry, and ACL size predict the structural properties of the human anterior cruciate ligament. J Orthop Res 29(7):993–1001CrossRefPubMed

32.

Hoher J, Offerhaus C, Steenlage E et al (2013) Impact of tendon suturing on the interference fixation strength of quadrupled hamstring tendon grafts. Arch Orthop Trauma Surg 133(9):1309–1314CrossRefPubMed

33.

Kennedy JC, Hawkins RJ, Willis RB et al (1976) Tension studies of human knee ligaments. Yield point, ultimate failure, and disruption of the cruciate and tibial collateral ligaments. J Bone Joint Surg Am 58(3):350–355PubMed

34.

Meuffels DE, Niggebrugge MJ, Verhaar JA (2009) Failure load of patellar tendon grafts at the femoral side: 10- versus 20-mm-bone blocks. Knee Surg Sports Traumatol Arthrosc 17(2):135–139CrossRefPubMed

35.

Noyes FR, Grood ES (1976) The strength of the anterior cruciate ligament in humans and Rhesus monkeys. J Bone Joint Surg Am 58(8):1074–1082PubMed

36.

Prietto C (1995) Anterior cruciate ligament repair in children. West J Med 163(6):567–568PubMedPubMedCentral

37.

Race A, Amis AA (1994) The mechanical properties of the two bundles of the human posterior cruciate ligament. J Biomech 27(1):13–24CrossRefPubMed

38.

Trent PS, Walker PS, Wolf B (1976) Ligament length patterns, strength, and rotational axes of the knee joint. Clin Orthop Relat Res 117:263–270PubMed

Titel: Can the gracilis replace the anterior cruciate ligament in the knee? A biomechanical study
verfasst von: Etienne Cavaignac
Regis Pailhé
Nicolas Reina
Jérôme Murgier
Jean Michel Laffosse
Philippe Chiron
Pascal Swider
Publikationsdatum: 05.11.2015
Verlag: Springer Berlin Heidelberg
Erschienen in: International Orthopaedics / Ausgabe 8/2016
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-015-3027-9

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen.
» Jetzt entdecken

Neu im Fachgebiet Orthopädie und Unfallchirurgie

25.04.2024 | Hypertonie | Nachrichten

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Can the gracilis replace the anterior cruciate ligament in the knee? A biomechanical study

Abstract

Purpose

Methods

Results

Conclusions

Arthropedia

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

Ärztliche Empathie hilft gegen Rückenschmerzen

Stereotaktische Radiatio schlägt konventionelle Bestrahlung

Vorsicht mit hohen NSAR-Dosen bei ankylosierender Spondylitis!

Update Orthopädie und Unfallchirurgie

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 8/2016

Biomechanical evaluation of different surgical techniques for treating patellar tendon ruptures

Dislocation and its recurrence after revision total hip arthroplasty

A multi-center analysis of adverse events among two thousand, three hundred and seventy two adult patients undergoing adult autologous stem cell therapy for orthopaedic conditions

A classification and grading system for Barton fractures

Two hundred years of orthopaedics in Wuerzburg—one hundred years of the Koenig-Ludwig-Haus

Lateral femoral cutaneous nerve injury with the direct anterior approach for total hip arthroplasty

Arthropedia

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

Ärztliche Empathie hilft gegen Rückenschmerzen

Stereotaktische Radiatio schlägt konventionelle Bestrahlung

Vorsicht mit hohen NSAR-Dosen bei ankylosierender Spondylitis!

Update Orthopädie und Unfallchirurgie