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Tension level during preconditioning influences hamstring tendon graft properties.

John J Elias1, Srianjana Kilambi, William J Ciccone

  • 1Medical Education and Research Institute of Colorado, Colorado Springs, Colorado, USA. jelias@agmc.org

The American Journal of Sports Medicine
|January 2, 2009
PubMed
Summary

Preconditioning hamstring tendon grafts at higher tension (160 N) significantly reduces postoperative loss of tension and stiffness in anterior cruciate ligament reconstruction, potentially decreasing knee laxity.

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Area of Science:

  • Biomedical Engineering
  • Orthopedic Surgery
  • Biomaterials Science

Background:

  • Hamstring tendon grafts are used for anterior cruciate ligament (ACL) reconstruction.
  • Graft preconditioning minimizes viscoelastic effects on stiffness and tension.
  • Viscoelasticity can negatively impact graft performance post-surgery.

Purpose of the Study:

  • To investigate the effect of increased preconditioning tension on hamstring tendon graft viscoelasticity.
  • To determine if higher preconditioning tension reduces postoperative loss of graft tension and stiffness.

Main Methods:

  • Controlled laboratory study involving six quadruple-strand hamstring tendon grafts.
  • Grafts were preconditioned in vitro at 80 N and 160 N tension levels.
  • Tension and stiffness were measured after relaxation periods and again after 3 hours.

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Main Results:

  • Preconditioning at 160 N resulted in significantly higher graft tension and stiffness compared to 80 N (P < .05).
  • At 3 hours post-preconditioning, 160 N resulted in 50 N tension and 173 N/mm stiffness, versus 21 N and 124 N/mm for 80 N.
  • The higher tension group (160 N) demonstrated less loss of tension and stiffness over time.

Conclusions:

  • Increasing preconditioning tension for hamstring tendon grafts effectively reduces postoperative viscoelastic-related loss of tension and stiffness.
  • This enhanced graft stability may lead to reduced postoperative knee laxity following ACL reconstruction.