Haut Donahue Tammy L, Howell Stephen M, Hull Maury L, Gregersen Colin
Biomedical Engineering Graduate Group, University of California at Davis, Davis, California 95616, USA.
Arthroscopy. 2002 Jul-Aug;18(6):589-97. doi: 10.1053/jars.2002.32617.
Because allograft tendons used to replace a torn anterior cruciate ligament are in short supply, it is useful to explore other possible graft sources. The purpose of this study was to determine whether a graft formed from a loop of either an anterior or posterior tibialis tendon has structural, material, and viscoelastic properties similar to those of a double-looped semitendinosus and gracilis (DLSTG) graft.
Completely randomized design.
Four structural and 3 material properties were determined for each type of graft (n = 10) by measuring the cross-sectional area, looping the tendon(s) over a post, gripping the free ends of the tendon(s) with a freeze clamp, and pulling the graft to failure by using a materials testing system. Two viscoelastic properties were determined for each type of graft (n = 10) by measuring the decrease in load under a constant displacement (i.e., stress relaxation test) and the increase in displacement under a constant load (i.e., creep test).
For grafts 95 mm in length, the ultimate load and ultimate displacement of a loop of anterior (4,122 N, 12.0 mm) and posterior tibialis (3,594 N, 12.5 mm) tendon were either similar to or significantly greater than those of the DLSTG graft (2,913 N, 8.4 mm) (P =.204 for the posterior tibialis ultimate load and P < or =.007 for the remaining quantities). The stiffness and cross-sectional area of the anterior (460 N/mm, 48.2 mm2) and posterior tibialis (379 N/mm, 41.9 mm2) grafts were similar to those of the DLSTG graft (418 N/mm, 44.4 mm2) (P > or =.283). The tensile modulus, stress at ultimate load, and strain at ultimate load of the anterior tibialis and posterior tibialis grafts were either similar to or significantly greater than those of the DLSTG graft. The decrease in load of the anterior tibialis and posterior tibialis grafts was either greater than or similar to that of the DLSTG graft for the relaxation test (P < or =.066). The increase in displacement of the anterior tibialis (0.3 mm) and posterior tibialis (0.4 mm) grafts was minimally but significantly greater than that of the DLSTG graft (0.2 mm) for the creep test (P < or =.004).
The structural, material, and viscoelastic properties of a single loop of anterior tibialis and posterior tibialis tendon are either better than or similar to those of a DLSTG graft. Consequently, single-loop grafts formed from tibialis tendons should function well as a replacement for a torn anterior cruciate ligament.
由于用于替代撕裂的前交叉韧带的同种异体肌腱供应短缺，探索其他可能的移植物来源很有必要。本研究的目的是确定由胫前肌腱或胫后肌腱的环形成的移植物是否具有与双环半腱肌和股薄肌（DLSTG）移植物相似的结构、材料和粘弹性特性。
完全随机设计。
通过测量每种移植物（n = 10）的横截面积，将肌腱绕过柱子，用冷冻夹夹住肌腱的自由端，并使用材料测试系统将移植物拉伸至破坏，来确定每种移植物的四种结构特性和三种材料特性。通过测量在恒定位移下的负荷降低（即应力松弛试验）和在恒定负荷下的位移增加（即蠕变试验），来确定每种移植物（n = 10）的两种粘弹性特性。
对于长度为95 mm的移植物，胫前肌腱环（4,122 N，12.0 mm）和胫后肌腱环（3,594 N，12.5 mm）的极限负荷和极限位移与DLSTG移植物（2,913 N，8.4 mm）相似或显著更大（胫后肌腱极限负荷P =.204，其余量P≤.007）。胫前肌腱（460 N/mm，48.2 mm²）和胫后肌腱（379 N/mm，41.9 mm²）移植物的刚度和横截面积与DLSTG移植物（418 N/mm，44.4 mm²）相似（P≥.283）。胫前肌腱和胫后肌腱移植物的拉伸模量、极限负荷下的应力和极限负荷下的应变与DLSTG移植物相似或显著更大。在松弛试验中，胫前肌腱和胫后肌腱移植物的负荷降低大于或类似于DLSTG移植物（P≤.066）。在蠕变试验中，胫前肌腱（0.3 mm）和胫后肌腱（0.4 mm）移植物的位移增加虽微小但显著大于DLSTG移植物（0.2 mm）（P≤.004）。
胫前肌腱和胫后肌腱单环的结构、材料和粘弹性特性优于或类似于DLSTG移植物。因此，由胫肌腱形成的单环移植物作为撕裂的前交叉韧带的替代物应能良好发挥作用。
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