Rowden N J, Sher D, Rogers G J, Schindhelm K
Department of Traumatic and Orthopaedic Surgery, Prince of Wales Hospital, Sydney, Australia.
Am J Sports Med. 1997 Jul-Aug;25(4):472-8. doi: 10.1177/036354659702500409.
The initial biomechanical properties of semitendinosus and patellar tendon autografts and their fixation strengths were investigated. Twenty fresh cadaveric knees from donors under 42 years of age were used in the study. After removing all soft tissues other than the anterior cruciate ligament, we determined the ultimate tensile strength (2195 +/- 427 N) and stiffness (306 +/- 80 N/mm) of the anterior cruciate ligament in nine knees. In six knees, anterior cruciate ligaments were reconstructed using an autologous patellar tendon graft with proximal and distal interference fit screws; this resulted in an ultimate tensile strength of 416 +/- 66 N. Five knees were reconstructed with quadruple-stranded (double-looped) semitendinosus tendons fixed proximally by a titanium button and braided tape and distally by tibial post screw. This resulted in an ultimate tensile strength of 612 +/- 73 N, which was significantly higher than the strength in the patellar tendon group. Graft stiffness did not differ between the groups and was 47 +/- 19 N/mm (N = 11). This study demonstrates that the reconstructed knees had only 20% to 30% of the ultimate tensile strength of the normal anterior cruciate ligament. In summary, the semitendinosus reconstruction using a button for proximal fixation is, at the time of surgery, approximately 50% stronger than patellar tendon reconstructions with similar stiffness.
对半腱肌和髌腱自体移植物的初始生物力学特性及其固定强度进行了研究。本研究使用了20个来自42岁以下供体的新鲜尸体膝关节。在去除前交叉韧带以外的所有软组织后，我们测定了9个膝关节前交叉韧带的极限拉伸强度（2195±427N）和刚度（306±80N/mm）。在6个膝关节中，使用自体髌腱移植物和近端及远端干涉配合螺钉重建前交叉韧带；这导致极限拉伸强度为416±66N。5个膝关节用四股（双环）半腱肌腱重建，近端用钛纽扣和编织带固定，远端用胫骨后螺钉固定。这导致极限拉伸强度为612±73N，显著高于髌腱组的强度。两组之间的移植物刚度没有差异，为47±19N/mm（N = 11）。本研究表明，重建后的膝关节极限拉伸强度仅为正常前交叉韧带的20%至30%。总之，在手术时，使用纽扣进行近端固定的半腱肌重建比具有相似刚度的髌腱重建大约强50%。
