Purpose
The purpose of this study was to thoroughly characterize the fan-folded iliotibial
band (FITB) allograft and compare it with anterior tibialis tendons (ATs) and native
anterior cruciate ligaments (ACLs) to determine whether it measures up to those tissues.
Methods
We compared the histologic structure, tensile strength to failure, creep, and stress-relaxation
properties of FITBs with those of ATs and ACLs. In vitro cytotoxicity and biocompatibility
of FITBs were also compared with ATs.
Results
No structural difference was observed between the tissues studied. FITB ultimate tensile
strength (3,459 ± 939 N) was not significantly different (P > .9999) from ultimate tensile strength of ATs (3,357 ± 111 N) and was significantly
greater (P = .0005) than that of ACLs (886 ± 254 N). No significant difference (P > .9999) was observed in the increase in length resulting from creep testing between
FITBs (9.5 ± 3.0 mm) and ATs (9.7 ± 4.0 mm). During stress-relaxation testing, FITBs
reached 181 ± 46 N, which was not significantly different (P > .9999) from ATs (166 ± 40 N). Finally, we showed that cytotoxicity of FITBs and
ATs was negligible. In vitro biocompatibility of FITBs and ATs was very good, whereas
FITBs had a higher propensity to favor the attachment and infiltration of cells that
proliferated for at least 4 weeks on their contact.
Conclusions
We found that FITBs, ACLs, and ATs shared a similar structure made of aligned collagen
fibers. No significant difference was observed between FITB and AT ultimate tensile
strength, creep, and stress-relaxation viscoelastic properties. Ultimate tensile strength
to failure of ACLs was lower than that of FITBs and ATs, whereas ACLs were superior
to both FITBs and ATs during creep and stress-relaxation testing. FITBs and ATs showed
low cytotoxicity and excellent biocompatibility in vitro, with a somewhat higher propensity
of FITBs to favor cell attachment and infiltration over time.
Clinical Relevance
This study suggests that FITBs have the potential to perform as well as ATs for ACL
reconstruction.
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Article info
Publication history
Published online: January 30, 2013
Accepted:
November 2,
2012
Received:
May 23,
2012
Footnotes
Supported by the University of Miami Tissue Bank, Department of Veterans Affairs, and Max Biedermann Institute for Biomechanics. The authors report that they have no conflicts of interest in the authorship and publication of this article.
Identification
Copyright
© 2013 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
