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Knee Surgery, Sports Traumatology, Arthroscopy
Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy 11/2012

01.11.2012 | Knee

Effects of graft pretensioning in anterior cruciate ligament reconstruction

verfasst von: Claude Guillard, Francois Lintz, Guillaume Anthony Odri, Denis Vogeli, Fabrice Colin, Sylvie Collon, Daniel Chappard, François Gouin, Henri Robert

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 11/2012

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Abstract

Purpose

Graft pretensioning is used in anterior cruciate ligament (ACL) reconstruction to prevent secondary slackening. Its effects on collagen fibrillar ultrastructure are not known. In this study, we hypothesized that graft pretensioning in ACL reconstruction creates ultrastructural changes detectable in scanning electron microscopy (SEM).

Methods

A prospective comparative study was carried out on 38 ACL reconstructions using a 4-strand semitendinosus graft. Samples were harvested intra-operatively before and after pretensioning for 30 s, 2 or 5 min. The images produced in SEM were analyzed using an original semi-quantitative «CIP» score taking into account collagen cohesion, integrity, and parallelism. Intra- and inter-tester reliability for the CIP score were tested.

Results

The CIP scores decreased by 3.5 (1.6) points after pretensioning (P < 0.05). Significant differences were found in the 5, 2 min and 30 s subgroups for the global CIP score. Relative decrease (Delta CIP) was significantly higher in the 2 and 5 min subgroups after pretensioning in comparison with the 30 s subgroups. Intra- and inter-tester reliability for the CIP score were 0.85 and 0.92 (P < 0.05).

Conclusion

Pretensioning ACL grafts resulted in alteration of the collagen fibrillar ultrastructure, detectable using SEM. These results confirm the existence of collagen ultrastructural changes after pretensioning that may be related to its duration.

Level of evidence

Prospective comparative study, Level II.
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Metadaten
Titel
Effects of graft pretensioning in anterior cruciate ligament reconstruction
verfasst von
Claude Guillard
Francois Lintz
Guillaume Anthony Odri
Denis Vogeli
Fabrice Colin
Sylvie Collon
Daniel Chappard
François Gouin
Henri Robert
Publikationsdatum
01.11.2012
Verlag
Springer-Verlag
Erschienen in
Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 11/2012
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-011-1833-1

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