Anterior cruciate ligament remnant-preserving and re-tensioning reconstruction: a biomechanical comparison study of three different re-tensioning methods in a porcine model.

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  • Additional Information
    • Source:
      Publisher: BioMed Central Country of Publication: England NLM ID: 100968565 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2474 (Electronic) Linking ISSN: 14712474 NLM ISO Abbreviation: BMC Musculoskelet Disord Subsets: MEDLINE
    • Publication Information:
      Original Publication: London : BioMed Central, [2000-
    • Subject Terms:
      Anterior Cruciate Ligament Injuries*/surgery ; Anterior Cruciate Ligament Reconstruction*; Animals ; Anterior Cruciate Ligament/surgery ; Biomechanical Phenomena ; Humans ; Knee Joint/surgery ; Swine
    • Abstract:
      Background: With the developments in the arthroscopic technique, anterior cruciate ligament (ACL) remnant-preserving reconstruction is gradually gaining attention with respect to improving proprioception and enhancing early revascularization of the graft. To evaluate the mechanical pull-out strength of three different methods for remnant-preserving and re-tensioning reconstruction during ACL reconstruction.
      Methods: Twenty-seven fresh knees from mature pigs were used in this study. Each knee was dissected to isolate the femoral attachment of ACL and cut the attachment. An MTS tensile testing machine with dual-screw fixation clamp with 30° flexion angle was used. The 27 specimens were tested after applying re-tensioning sutures with No. 0 polydioxanone (PDS), using the single stitch (n = 9), loop stitch (n = 9), and triple stitch (n = 9) methods. We measured the mode of failure, defined as (1) ligament failure (longitudinal splitting of the remnant ACL) or (2) suture failure (tearing of the PDS stitch); load-to-failure strength; and stiffness for the three methods. Kruskal-Wallis test and Mann-Whitney U-test were used to compare the variance of load-to-failure strength and stiffness among the three groups.
      Results: Ligament failure occurred in all cases in the single stitch group and in all but one case in the triple stitch group. Suture failure occurred in all cases in the loop stitch group and in one case in the triple stitch group. The load-to-failure strength was significantly higher with loop stich (91.52 ± 8.19 N) and triple stitch (111.1 ± 18.15 N) than with single stitch (43.79 ± 11.54 N) (p = 0.002). With respect to stiffness, triple stitch (2.50 ± 0.37 N/mm) yielded significantly higher stiffness than the other methods (p = 0.001).
      Conclusions: The results suggested that loop stitch or triple stitch would be a better option for increasing the mechanical strength when applying remnant-preserving and re-tensioning reconstruction during ACL reconstruction.
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    • Grant Information:
      HI15C2424 the Ministry of Health & Welfare, Republic of Korea; NRF-2017R1A2B3007362 the Ministry of Science and ICT
    • Contributed Indexing:
      Keywords: ACL; Biomechanical; Re-tensioning; Remnant-preserving
    • Publication Date:
      Date Created: 20210204 Date Completed: 20210514 Latest Revision: 20210514
    • Publication Date:
      20240105
    • Accession Number:
      PMC7860227
    • Accession Number:
      10.1186/s12891-021-03955-w
    • Accession Number:
      33536007