Thambyah A, Thiagarajan P, Goh J C
Faculty of Medicine, Department of Orthopaedic surgery, National University of Singapore, Lower Kent Ridge Road, 119074, Singapore.
Clin Biomech (Bristol). 2000 Dec;15(10):756-60. doi: 10.1016/s0268-0033(00)00047-4.
To compare the stiffness and maximum strength between the untwisted and twisted free-tendon.
22 twisted and untwisted sectioned-specimens of human cadaver patellar tendons were used and pulled to failure to obtain load-deformation profiles from which stiffness, maximum load to failure and elastic elongation limit were derived.
In the reconstruction of the deficient anterior cruciate ligament, the use of the central one-third of the patellar tendon is a well-established procedure in which, prior to insertion, the tendon graft may be twisted to mimic the natural orientation of the anterior cruciate ligament in the knee joint.
The untwisted tendons had a mean stiffness of 36.5 kg/mm (SD, 16.6 kg/mm) and maximum load of 165.9 kg (SD, 86.8 kg). With a 90 degrees twist, the average stiffness of the twisted tendon was 66.5 kg/mm (SD, 25.4 kg/mm), with maximum load at 364.5 kg (SD, 109.9 kg), an increase of over 100%. The elastic elongation limit, or allowable elongation before permanent deformation or failure, was significantly larger in twisted tendons by 35%.
Twisting increased the resistance to deformation of the tendon in this study. Relevance The finding supports the surgical practice of pre-twisting tendon grafts for anterior cruciate ligament reconstruction, based on the premise that a stronger and stiffer graft provides a more favourable outcome.
比较未扭转和扭转的游离肌腱之间的刚度和最大强度。
使用22个经切片处理的人尸体髌腱标本，分为扭转组和未扭转组，拉伸至破坏以获得载荷-变形曲线，从中得出刚度、最大破坏载荷和弹性伸长极限。
在重建缺损的前交叉韧带时，使用髌腱中三分之一是一种成熟的手术方法，在植入前，肌腱移植物可能会被扭转以模拟膝关节前交叉韧带的自然方向。
未扭转的肌腱平均刚度为36.5kg/mm（标准差，16.6kg/mm），最大载荷为165.9kg（标准差，86.8kg）。扭转90度后，扭转肌腱的平均刚度为66.5kg/mm（标准差，25.4kg/mm），最大载荷为364.5kg（标准差，109.9kg），增加超过100%。扭转肌腱的弹性伸长极限，即永久变形或破坏前的允许伸长，显著增大35%。
在本研究中，扭转增加了肌腱的抗变形能力。相关性：该发现支持在前交叉韧带重建中对肌腱移植物进行预扭转的手术操作，前提是更强更硬的移植物能带来更有利的结果。
