The biomechanical effects of graft rotation on ACL reconstruction tunnel mismatch

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art_OLIVEIRA_The_biomechanical_effects_of_graft_rotation_on_ACL_2017.PDF (790.36 KB)
Citações na Scopus
1
Tipo de produção
article
Data de publicação
2017
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
SPRINGER
Autores
FUSO, Fernando Augusto Freitas
LAGES, Marco Martins
Citação
KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, v.25, n.4, p.1255-1263, 2017
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Bone block protrusion out of the tibial tunnel due to a relatively long graft is a common complication in anterior cruciate ligament surgical reconstruction with a patellar tendon. One possible solution is to shorten the patellar tendon graft already fixed in the femur by applying external rotation. This study aimed to evaluate the degree of shortening and biomechanical changes in porcine patellar grafts subjected to relatively higher degrees of rotation. Data obtained with rotations of 0A degrees, 540A degrees, 720A degrees, and 900A degrees were compared. Forty patellar porcine ligaments were subjected to biomechanical tests of degree of shortening, modulus of elasticity and maximum tension in the tendon before rupture. Tests were conducted using a universal mechanical testing machine and a computerized system for acquiring strength and deformation data. Progressive shortening of the patellar ligament occurred with rotations of 0A degrees, 540A degrees and 720A degrees. However, the degree of shortening showed no statistically significant difference as rotation increased from 720A degrees to 900A degrees. Decreased modulus of elasticity was observed compared with the graft rotation at 0A degrees in all groups tested, but no statistically significant differences were observed among 540A degrees, 720A degrees and 900A degrees. The maximum tension of the patellar tendon showed no change before rupture, regardless of the degree of rotation. Rotating the patellar tendon is an efficient method for shortening a relatively long graft; however, more biomechanical studies are necessary to recommend this technique in clinical practice owing to the resulting decrease in graft stiffness that could compromise knee stability.
Palavras-chave
ACL reconstruction, Tunnel mismatch, Rotational stability, Patellar tendon, Graft rotation
URI
https://observatorio.fm.usp.br/handle/OPI/20117
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MOT
Artigos e Materiais de Revistas Científicas - HC/IOT
Artigos e Materiais de Revistas Científicas - LIM/41