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Biomechanical Comparison of Native Acetabular Labrum, Fresh-Frozen Meniscus, and Fresh-Frozen Anterior Tibialis
Ashwin R Garlapaty1,2, Corder Lehenbauer1,2, Will Bezold2
1School of Medicine, University of Missouri, Columbia, Missouri, USA.
Background:
Acetabular labral tears can lead to hip pain and dysfunction and progress to osteoarthritis if left untreated. While surgical repair is the gold standard, reconstruction with grafts is necessary in cases of irreparable labral damage. Clinical data suggest that meniscal allografts may offer superior outcomes as compared with anterior tibialis tendon allografts, but biomechanical comparisons remain limited.
Hypothesis/Purpose:
This study aimed to compare the tissue properties of the native acetabular labrum, fresh-frozen medial meniscal allograft, and fresh-frozen anterior tibialis tendon allograft. The null hypothesis was that the fresh-frozen medial meniscus will not have statistically different biomechanical properties to the native labrum and fresh-frozen anterior tibialis tendon.
Study Design:
Controlled laboratory study.
Methods:
Samples of the native labrum (n = 6), fresh-frozen meniscus (n = 6), and fresh-frozen anterior tibialis tendon (n = 6) were standardized and biomechanically tested using a 3-phase protocol on an Instron materials testing machine. Properties measured included ultimate strength, yield force, yield strength, stiffness, Young modulus, and work to failure. One-way analysis of variance with post hoc Tukey was performed to determine statistically significant differences among tissue types. Significance was set at P < .05.
Results:
Ultimate strength, yield force, and Young modulus were not significantly different across tissue types. Native labrum exhibited significantly higher yield strength (mean ± SD; 48.25 ± 14.56 MPa) when compared with the meniscus (26.69 ± 6.51 MPa) and anterior tibialis tendon (27.50 ± 5.02 MPa; P = .002). Stiffness was greater in the anterior tibialis tendon (159.35 ± 44.11 N/mm) than in the native labrum (89.07 ± 26.76 N/mm) and meniscus (112.84 ± 56.74 N/mm; P = .027). Work to failure was highest in the native labrum (1143.62 ± 551.31 N·mm) versus the meniscus (310.44 ± 168.29 N·mm) and tibialis tendon (265.93 ± 131.48 N·mm; P = .001).
Conclusion:
The stiffness of the medial meniscus tested closer to the native labrum than the anterior tibialis, but both grafts had significantly lower yield strength and work to failure than the native labrum. Together, the results indicate that the medial meniscus and anterior tibialis are viable graft options, but they do not replicate the tissue properties of the native labrum.
Clinical Relevance:
These findings support the use of medial meniscal allograft in acetabular labral reconstruction given its biomechanical similarity to native labral tissue, reinforcing prior clinical data and aiding graft selection in hip preservation surgery.
