Strauss Marc J, Miles Jon W, Kennedy Mitchell L, Dornan Grant J, Moatshe Gilbert, Lind Martin, Engebretsen Lars, LaPrade Robert F
The Steadman Philippon Research Institute, Vail, CO, USA.
Department of Orthopedics, Oslo University Hospital, Kirkeveien 166, 0450, Oslo, Norway.
Knee Surg Sports Traumatol Arthrosc. 2022 May;30(5):1786-1794. doi: 10.1007/s00167-021-06738-x. Epub 2021 Sep 30.
Despite increasing interest in utilizing quadriceps tendon (QT) grafts in anterior cruciate ligament reconstruction (ACLR), data on the optimal quadriceps graft thickness are limited. The purpose of this study was to characterize the mechanical properties for the quadriceps tendon, comparing full-thickness (FT) QT grafts with and without bone to a partial-thickness (PT) QT graft, and comparing the three QT grafts to four-stranded semitendinosus (4-SST) and bone-patellar tendon-bone (BTB) grafts and one experimental graft, the two-stranded rectus femoris (RF).
Forty-eight (n = 48) young cadaveric grafts (mean age 32 ± 6 years) were utilized for testing with N = 8 specimens in each of the following groups; (1) FT QT with bone, (2) FT QT without bone, (3) PT QT without bone, (4) BTB, (5) RF, and (6) 4-SST. Each specimen was harvested and rigidly fixed in custom clamps to a dynamic tensile testing machine for biomechanical evaluation. Graft ultimate load and stiffness were recorded. Independent groups one-factor ANOVAs and Tukey's pairwise comparisons were performed for statistical analyses.
FT QT with bone and 4-SST grafts demonstrated similar ultimate loads to BTB grafts (both n.s), whereas PT QT demonstrate statistically significantly lower ultimate loads to BTB grafts (n.s) and 4-SST grafts (n.s). Furthermore, no statistically significant differences were observed between the ultimate loads of FT QT vs. PT QT grafts without bone (n.s) or between FT QT with vs. without bone (n.s). FT QT grafts with bone did not demonstrate statistically significantly greater ultimate loads than PT QT grafts without bone (n.s). The RF graft demonstrated statistically significantly lower ultimate loads to BTB grafts (p < 0.005) and 4-SST grafts (p < 0.014).
Full thickness QT grafts with bone had similar material properties to BTB and a 4-SST grafts, while Partial thickness QT graft without bone had significantly lower material properties than BTB and 4-SST, in a biomechanical setting.
尽管在利用股四头肌肌腱（QT）移植物进行前交叉韧带重建（ACLR）方面的兴趣日益增加，但关于最佳股四头肌移植物厚度的数据有限。本研究的目的是描述股四头肌肌腱的力学性能，将带骨和不带骨的全层（FT）QT移植物与部分厚度（PT）QT移植物进行比较，并将这三种QT移植物与四股半腱肌（4-SST）、骨-髌腱-骨（BTB）移植物以及一种实验性移植物——两股股直肌（RF）进行比较。
使用48个年轻尸体移植物（平均年龄32±6岁）进行测试，每组8个标本；（1）带骨FT QT，（2）不带骨FT QT，（3）不带骨PT QT，（4）BTB，（5）RF，以及（6）4-SST。每个标本被采集并牢固地固定在定制夹具中，连接到动态拉伸试验机上进行生物力学评估。记录移植物的极限载荷和刚度。进行独立组单因素方差分析和Tukey成对比较以进行统计分析。
带骨FT QT和4-SST移植物的极限载荷与BTB移植物相似（均无统计学意义），而PT QT的极限载荷在统计学上显著低于BTB移植物（无统计学意义）和4-SST移植物（无统计学意义）。此外，不带骨的FT QT与PT QT移植物的极限载荷之间（无统计学意义）或带骨与不带骨的FT QT之间（无统计学意义）均未观察到统计学显著差异。带骨FT QT移植物的极限载荷并不比不带骨的PT QT移植物在统计学上显著更高（无统计学意义）。RF移植物的极限载荷在统计学上显著低于BTB移植物（p<0.005）和4-SST移植物（p<0.014）。
在生物力学环境中，带骨的全层QT移植物与BTB和4-SST移植物具有相似的材料特性，而不带骨的部分厚度QT移植物的材料特性明显低于BTB和4-SST。
