Effects of Graft Pretensioning in Anterior Cruciate Ligament Reconstruction

Overview

Journal Knee Surg Sports Traumatol Arthrosc

Publisher Wiley

Specialties Emergency Medicine
General Surgery
Orthopedics

Date 2012 Jan 6

PMID 22218827

Citations 11

Authors

Claude Guillard

Francois Lintz

Guillaume Anthony Odri

Denis Vogeli

Fabrice Colin

Sylvie Collon

Daniel Chappard

Francois Gouin

Henri Robert

Affiliations

Soon will be listed here.

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.

Citing Articles

Application of the 3D-MRI on post-operative graft assessment in adolescent patients with ACL reconstruction: A minimal 2-year follow-up.

Wang X, Qi Y, Bao H, Xu Y Front Surg. 2023; 9:1070324.

PMID: 36684206 PMC: 9852513. DOI: 10.3389/fsurg.2022.1070324.

Akazawa T, Miyamoto N, Nishio H, Miyamoto-Mikami E, Kinoshita M, Kobayashi Y J Orthop Surg Res. 2022; 17(1):501.

PMID: 36403051 PMC: 9675133. DOI: 10.1186/s13018-022-03395-9.

Optical Microscopy and Electron Microscopy for the Morphological Evaluation of Tendons: A Mini Review.

Xu M, Liu J, Sun J, Xu X, Hu Y, Liu B Orthop Surg. 2020; 12(2):366-371.

PMID: 32096911 PMC: 7189050. DOI: 10.1111/os.12637.

Effects of graft preconditioning on γ-irradiated deep frozen tendon allografts used in anterior cruciate ligament reconstruction.

Zheng X, Xu W, Gu J, Hu Y, Cui M, Feng Y Exp Ther Med. 2018; 16(2):1338-1342.

PMID: 30116383 PMC: 6090265. DOI: 10.3892/etm.2018.6338.

Features of human autologous hamstring graft elongation after pre-tensioning in anterior cruciate ligament reconstruction.

Fujii M, Furumatsu T, Miyazawa S, Tanaka T, Inoue H, Kodama Y Int Orthop. 2016; 40(12):2553-2558.

PMID: 27695924 DOI: 10.1007/s00264-016-3298-9.

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