Scapholunate ligament reconstruction using an acellular dermal matrix: a mechanical study

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Sports Medicine

Background:

• Chronic scapholunate ligament instability is a significant cause of wrist pain and dysfunction.
• Various surgical techniques exist for scapholunate ligament reconstruction, but their biomechanical properties vary.
• Acellular dermal matrix (ADM) presents a potential alternative graft material for ligamentous reconstruction.

Purpose of the Study:

• To evaluate the biomechanical properties of scapholunate ligament reconstruction using ADM.
• To compare the biomechanical performance of ADM reconstruction to native scapholunate ligaments and previously described techniques.

Main Methods:

• Fifteen cadaveric wrist specimens were used, with the scapholunate ligament harvested.
• Ten specimens underwent reconstruction using ADM and micro suture anchors; five served as intact controls.
• Tensile testing was performed to determine ultimate failure force, displacement, stiffness, and energy to failure.

Main Results:

• Intact scapholunate ligaments failed at a mean force of 172 N and stiffness of 74 N/mm.
• ADM reconstructions with 1.0-mm and 1.5-mm matrices showed mean failure forces of 77 N and 111 N, respectively.
• Failure modes differed between ADM thicknesses, occurring at the suture-matrix or bone-suture anchor interface.

Conclusions:

• Scapholunate ligament reconstruction with ADM and suture anchors exhibits biomechanical properties comparable to other described reconstruction methods.
• The ADM technique shows promise as a potential treatment for chronic scapholunate instability, meriting further clinical study.