Biomechanical Testing of Commercially Available Soft-Tissue Augmentation Materials
Received 29 November 2008; accepted 26 May 2009. published online 05 October 2009.
Purpose
To evaluate several physical properties and physical dimensions of commercially available soft-tissue augmentation devices.
Methods
After 2 × 5–cm strips of several graft materials were hydrated, load elongation, cyclic and permanent displacement, percent elastic displacement, tensile modulus, stiffness, and ultimate load-to-failure strength were determined. With a 5-N preload, 30 cyclic loads between 5 N and 50 N were applied at 12.5 mm/s followed by destructive testing. A vertical stitch suture retention test was also performed.
Results
SportMesh (Biomet Sports Medicine, Warsaw, IN) displaced more than any other material (P < .001). GraftJacket MaxForce Extreme (Wright Medical Technology, Arlington, TN) and Allopatch HD 2 (Musculoskeletal Tissue Foundation, Edison, NJ) displaced more than RC Allograft (Arthrex, Naples, FL) (P < .05). Percent elastic deformation did not differ among these materials. OrthAdapt (Pegasus Biologics, Irvine CA) had a higher tensile modulus than RC Allograft, SportMesh, and Allopatch HD 2 (P < .001). Allopatch HD 1 and GraftJacket MaxForce Extreme had a higher tensile modulus than RC Allograft and SportMesh. GraftJacket MaxForce had a higher tensile modulus than RC Allograft (P < .001). GraftJacket MaxForce Extreme stiffness was greater than that of OrthAdapt and SportMesh (P < .001), and GraftJacket MaxForce, RC Allograft, Allopatch HD 1, and Allopatch HD 2 stiffness was greater than that of SportMesh (P < .001). The ultimate strength of GraftJacket MaxForce, GraftJacket MaxForce Extreme, Allopatch HD 1, and Allopatch HD 2 was greater than that of OrthAdapt and SportMesh (P < .05). Acellular human collagen matrix grafts (GraftJacket and Allopatch HD) showed greater suture retention strength than RC Allograft and SportMesh, which were both stronger than OrthAdapt (P < .05).
Conclusions
The acellular human collagen matrix grafts showed greater elongation than the cuff tendon allograft (RC Allograft), although SportMesh elongated more than all other materials tested. The tensile modulus, which is “normalized” to eliminate differences in the size of the tissue tested, was greater for the OrthAdapt material than for GraftJacket, Allopatch, RC Allograft, and SportMesh. Suture retention strength was greatest in the acellular human collagen matrix grafts (GraftJacket and Allopatch), whereas both SportMesh and RC Allograft had greater suture retention strength than OrthAdapt.
Clinical Relevance
Acellular human collagen matrix grafts (GraftJacket and Allopatch) are stronger after cyclic loading than SportMesh and OrthAdapt and show greater stiffness.
Plano Orthopedic Sports Medicine and Spine Center, Plano, Texas, U.S.A.
Address correspondence and reprint requests to F. Alan Barber, M.D., Plano Orthopedic Sports Medicine and Spine Center, 5228 W Plano Pkwy, Plano, TX 75093, U.S.A.
Supported by grants from Arthrex, Wright Medical Technology, Musculoskeletal Tissue Foundation, Allosource, Pegasus Biologics, and Biomet Sports Medicine. Research was performed at Arthrex. The authors report no conflict of interest.
ABSTRACT