Converting round tendons to flat tendon constructs: Does the preparation process have an influence on the structural...

Area of Science:

• Orthopedic surgery
• Biomechanical engineering
• Sports medicine

Background:

• Hamstring tendon grafts are commonly used in anterior cruciate ligament (ACL) reconstruction.
• Current graft preparation methods may not optimally match the geometry of certain anatomical structures.
• Evaluating alternative graft shapes is crucial for improving surgical outcomes.

Purpose of the Study:

• To assess the biomechanical properties of porcine flexor tendons processed into a flat shape.
• To compare the structural integrity of flat tendon constructs with their original round form.
• To determine the suitability of flat tendon grafts for replacing or augmenting native flat anatomical structures.

Main Methods:

• Porcine flexor tendons were utilized for their anatomical similarity to human hamstring tendons.
• Tendons were divided into two groups: one processed into a flat shape, the other retained in its round form.
• A uniaxial testing machine was used to load tendons to failure, measuring stiffness, yield load, and maximum load.

Main Results:

• No statistically significant differences were observed in stiffness between round and flat tendon constructs.
• Yield load and maximum load also showed no significant differences between the two groups.
• The processing of tendons into a flat shape did not compromise their structural integrity.

Conclusions:

• Flat-shaped tendon grafts exhibit comparable structural properties to their native round counterparts.
• Flat tendon constructs represent a biomechanically stable option for graft augmentation or reconstruction.
• This technique may enhance the suitability of tendon grafts for repairing native flat structures like the medial collateral ligament (MCL), medial patellofemoral ligament (MPFL), or ACL.