Summary: we evaluated the biomechanical effects of initial graft tension in different flexion angles during fixation of various tendon grafts in the tibial canal. We evaluated the advantage of augmenting the discarded tendon during ACL reconstruction with Hamstring tendon surgery as a technique to improve the outcome in a finite element simulation.

Surgical reconstruction of the anterior cruciate ligament is a common practice to treat the disability or chronic instability of the knee. Several factors associated with success or failure of the ACL reconstruction, including surgical technique and graft material and graft tension. We aimed to show how we can optimize the graft properties and achieve better post surgical outcomes during ACL reconstruction using 3-dimensional computational finite element simulation.

Methods

In this paper, 3-dimensional model of the knee was constructed to investigate the effect of graft tensioning on the knee joint biomechanics. Four different grafts were compared: 1) bone-patellar tendon-bone graft (BPTB) 2) Hamstring tendon 3) BPTB and a band of gracilis 4) Hamstring and a band of gracilis. The initial graft tension was set as ?0, 20, 40, or 60N?. The anterior loading was set to 134 N.
Findings: According to the previous papers the best pretention needed for Acl reconstruction is 60 N and the animal studies showed that this pretention increase the risk of the problem in revascularization and graft remodelingand Healing .Our study shows that the use of the discarded gracilis tendon, which usually excised after graft fixation, could be associated with a host of merits. Our results show that preserving this excess part of gracilis and attach to the main graft would decrease the required pretention load and, subsequently, could optimize biomechanical and histological properties of the knee.

Conclusion

Required pretension during surgery will have decreased significantly by adding a band of gracilis to the proper graft. Therefore, in addition to achieving normal stability of the knee, we can have lower risk of degradation

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How To Optimize The Graft Properties During Acl Reconstruction? Impact Of The Combining A Band Of discarded hamstring With The Former Graft

How To Optimize The Graft Properties During Acl Reconstruction? Impact Of The Combining A Band Of discarded hamstring With The Former Graft

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How To Optimize The Graft Properties During Acl Reconstruction? Impact Of The Combining A Band Of discarded hamstring With The Former Graft

How To Optimize The Graft Properties During Acl Reconstruction? Impact Of The Combining A Band Of discarded hamstring With The Former Graft

Methods

Conclusion