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首页> 外文期刊>American Journal of Sports Medicine >Biomechanical Testing of Three Alternative Quadrupled Tendon Graft Constructs With Adjustable Loop Suspensory Fixation for Anterior Cruciate Ligament Reconstruction Compared With Four-Strand Grafts Fixed With Screws and Femoral Fixed Loop Devices
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Biomechanical Testing of Three Alternative Quadrupled Tendon Graft Constructs With Adjustable Loop Suspensory Fixation for Anterior Cruciate Ligament Reconstruction Compared With Four-Strand Grafts Fixed With Screws and Femoral Fixed Loop Devices

机译：与用螺钉和股骨固定回路装置固定的四股移植物相比，具有可调节环悬浮腱接枝固定的三种替代四分之三肌腱移植构建体的生物力学测试

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Background: Quadrupled semitendinosus (ST) grafts for anterior cruciate ligament (ACL) reconstruction have advantages of greater graft diameter and gracilis (G) preservation compared with doubled ST-G grafts. However, a paucity of biomechanical data are available regarding different preparation techniques for these constructs. Purpose: To biomechanically analyze 3 alternative tendon constructs fixed with adjustable suspensory fixation devices on the femur and tibia compared with a matched 4-strand construct fixed with a tibial screw and femoral fixed loop device. Study Design: Controlled laboratory study. Methods: Three alternative quadrupled tendon preparation techniques with suspensory fixation (grafts constructs A, B, and C) were compared with a 4-strand screw-fixed loop device construct (graft construct D) in matched diameter bovine tendon graft and porcine tibia models. Graft constructs were tested with a 3-stage cyclic loading protocol (1000 cycles in position control and 1000 cycles each from 10 to 250 N and from 10 to 400 N), followed by a pull to failure. In graft construct A, the graft ends were whipstitched and tied over the tibial button; in graft construct B, the graft ends functioned as pulleys; and in graft construct C, a continuous loop was created. Initial, dynamic, and total elongation, stiffness, and ultimate failure load were recorded. Results: Graft construct D had the highest initial (0.51 +/- 0.29 mm) and total (3.53 +/- 0.98 mm) elongation compared with the 3 quadrupled constructs (P < .001 each). Graft construct B had lower total elongation (2.13 +/- 0.31 mm) compared with graft construct A (2.40 +/- 0.30 mm) (P = .004) and graft construct C (2.53 +/- 0.21 mm) (P = .007). Graft construct C had a higher ultimate failure load (1097 +/- 79 N) compared with graft construct A (988 +/- 112 N) (P = .001), graft construct B (973 +/- 137 N) (P = .022), and graft construct D, which had the lowest failure load (767 +/- 182 N) (P < .001). Conclusion: The 3 quadrupled tendon suspensory fixation constructs exhibited small yet statistically significant biomechanical differences among each other. Constructs that used tibial screw fixation had lower ultimate failure load and higher total elongation compared with the quadrupled tendon
机译：背景：与前曲韧带（ACL）重建的四分类半质毒素（ST）移植物具有更大的移植直径和Gracilis（g）保存的优点，与加倍的ST-G移植物相比。然而，有关于这些构建体的不同制剂技术的生物力学数据的缺乏。目的：与股骨和胫骨上的可调节的悬挂固定装置进行生物力学分析，与用胫骨螺钉和股骨固定回路装置固定的匹配的4股结构相比，固定在股骨和胫骨上固定的3个替代肌腱构建体。研究设计：受控实验室研究。方法：将具有悬浮型固定（移植物构建A，B和C）的三种替代的二次替代肌腱制备技术与匹配直径牛筋接枝和猪胫骨模型中的4股螺钉固定回路装置构建体（移植物构建体D）进行比较。用3阶段环状加载方案（在位置控制中1000个循环和1000个循环的接枝构建体和10至250n和10至400n）进行测试，然后拉动失效。在移植物构造A中，移植物端部呈呈胫骨按钮并捆扎在胫骨按钮上;在移植物构造B中，移植物端部用作滑轮;在移植物构造C中，产生连续环。记录初始，动态和总伸长率，刚度和最终失效负载。结果：与3个四倍体构建体相比，移植物构造D具有最高的初始（0.51 +/- 0.29 mm）和总（3.53 +/- 0.98 mm）伸长率（每次p <.001）。与移植物构建体（2.40 +/- 0.30mm）（P = .004）和接枝构建C（2.53 +/- 0.21mm）相比，移植物构建体B具有较低的总伸长率（2.13 +/- 0.31mm）（2.53 +/- 0.21mm）（P =。 007）。与移植物构建体（988 +/- 112N）（p = .001），移植物构建体B（973 +/- 137 n）（p = .022）和接枝构建体D，具有最低故障载荷（767 +/- 182 n）（p <.001）。结论：彼此之间表现出小又统计学的生物力学差异。与四射肌腱相比，使用胫骨螺钉固定的结构具有较低的终极故障负载和更高的总伸长率

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