PURPOSE: To investigate the effect of graft length within the bone tunnel on tendon-bone healing at an early stage after anterior cruciate ligament (ACL) reconstruction using Achilles tendon autograft in a canine model. METHODS: We divided 40 adult dogs into 4 groups (n = 10 per group). Each dog underwent ACL reconstruction with Achilles tendon autograft in both knees. In groups I, II, III, and IV, the graft length within the tibia tunnel was 5 mm, 10 mm, 15 mm, and 20 mm, respectively. Five dogs in each group were killed 6 and 12 weeks postoperatively, with 3 knees used for histologic observation and 7 knees for mechanical testing. RESULTS: Six weeks after surgery, the histologic scores in group I were lower than those in the other groups (P < .01) and those in group II were lower than those in group III and group IV (P < .01). However, there was no difference between group III and group IV (P > .05). At 12 weeks, there were no significant differences in histologic scores between groups (P > .05). The biomechanical test at 6 weeks showed that the mean graft pullout strength improved from group I to group IV. Except between groups III and IV (P = .142), there was a significant difference in the pullout strength among other groups. At week 12, the failure points were in the midsubstance of most specimens and more tibial-side graft pullout was found in group I than in the other groups (P < .001). CONCLUSIONS: The histologic maturity and biomechanical strength of the tendon-bone junction after ACL reconstruction in dogs will be delayed at an early stage if the graft length in the bone tunnel is less than 15 mm. CLINICAL RELEVANCE: There is a minimal acceptable amount of intratunnel tendon graft to allow satisfactory early tendon-bone healing, and attempts to save tendon graft length that lower the amount of intratunnel graft below a minimum of 15 mm should be avoided.
PURPOSE: To investigate the effect of graft length within the bone tunnel on tendon-bone healing at an early stage after anterior cruciate ligament (ACL) reconstruction using Achilles tendon autograft in a canine model. METHODS: We divided 40 adult dogs into 4 groups (n = 10 per group). Each dog underwent ACL reconstruction with Achilles tendon autograft in both knees. In groups I, II, III, and IV, the graft length within the tibia tunnel was 5 mm, 10 mm, 15 mm, and 20 mm, respectively. Five dogs in each group were killed 6 and 12 weeks postoperatively, with 3 knees used for histologic observation and 7 knees for mechanical testing. RESULTS: Six weeks after surgery, the histologic scores in group I were lower than those in the other groups (P < .01) and those in group II were lower than those in group III and group IV (P < .01). However, there was no difference between group III and group IV (P > .05). At 12 weeks, there were no significant differences in histologic scores between groups (P > .05). The biomechanical test at 6 weeks showed that the mean graft pullout strength improved from group I to group IV. Except between groups III and IV (P = .142), there was a significant difference in the pullout strength among other groups. At week 12, the failure points were in the midsubstance of most specimens and more tibial-side graft pullout was found in group I than in the other groups (P < .001). CONCLUSIONS: The histologic maturity and biomechanical strength of the tendon-bone junction after ACL reconstruction in dogs will be delayed at an early stage if the graft length in the bone tunnel is less than 15 mm. CLINICAL RELEVANCE: There is a minimal acceptable amount of intratunnel tendon graft to allow satisfactory early tendon-bone healing, and attempts to save tendon graft length that lower the amount of intratunnel graft below a minimum of 15 mm should be avoided.
Authors: Meghan W Richardson; Nicholas D Tsouris; Chaudry R Hassan; Justen H Elbayar; Yi-Xian Qin; David E Komatsu; Angelo V Rizzi; James M Paci Journal: Arthroscopy Date: 2019-04-12 Impact factor: 4.772
Authors: Michael W Mariscalco; Robert A Magnussen; Joshua Mitchell; Angela D Pedroza; Morgan H Jones; Jack T Andrish; Richard D Parker; Christopher C Kaeding; David C Flanigan Journal: Eur Orthop Traumatol Date: 2015-03-01