Purpose
To evaluate the initial safety of the combined use of ultra-high molecular weight
polyethylene (UHMWPE) sutures for suture augmentation (SA) in a porcine ACL reconstruction
model and examine whether the procedure can affect the anterior knee laxity and structural
properties of the tendon graft itself, influence histological remodeling, and cause
a foreign body-induced inflammation.
Methods
Ten pigs were divided into SA and non-SA Groups to undergo ACL reconstruction using
an autologous semitendinosus tendon with and without SA, respectively. At 12 weeks
postoperatively, the tibial fixation of the grafted tendon and SA was removed, and
the anterior knee laxity and structural characteristics of the grafted tendon were
evaluated for mechanical testing. Histological evaluation, including the ligament tissue
maturation index (LTMI) score and the presence or absence of foreign-body reaction,
was evaluated.
Results
There was no significant difference in anterior laxity between the two groups (SA
Group, 1.19 ± 0.78 mm; non-SA Group, 1.08 ± 0.42 mm; P = 1). There were no significant differences in maximum load failure, yield strength,
stiffness, elongation at failure, and the LTMI score between the two groups (P = 0.31, 1, 1, 1, and 0.24, respectively). All grafted tendons showed no foreign-body
reactions.
Conclusion
Suture augmentation did not have significant effect on the anterior knee laxity and
the structural properties of the grafted tendon, interfere with histological remodeling,
or cause foreign body-induced reactions.
Clinical Relevance
The results of our study may lay the foundation for further clinical studies to verify
the usefulness of ACL reconstruction with SA.
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Article info
Publication history
Published online: January 09, 2023
Accepted:
October 20,
2022
Received:
April 2,
2022
Footnotes
See commentary on page 1025
The authors report no conflicts of interest in the authorship and publication of this article. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Identification
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© 2023 by the Arthroscopy Association of North America
