This paper is only available as a PDF. To read, Please Download here.
Abstract
This paper reports the experience with anterior cruciate ligament (ACL) substitution
by standardized pedicled strips of the iliotibial band, fixed to the tibia and femur
with a bone-peg fixation technique. Thirty-two young adult (± one year old) Labrador
dogs were used for the experiments (58 transplant knees and six controls). The posttransplantation
period ranged from day zero to three years postoperatively. Of the transplants, there
were five failures. Forty-seven knees served for gross, photographic, and histologic
examination. In 17 knees, the transplants were submitted to tensile testing in an
Instron testing machine. The behavior of the ACL transplants was as follows: the transplants
became necrotic in a short period of time, but after day four, a process of creeping
substitution took place. At 12–16 weeks, a newly formed ligament was seen with a striking
macroscopic resemblance to the normal ACL. However, its collagen fibers were coarser
and more undulant, and they were fixed to the bony interfaces with Sharpey-like fibers.
When these rather good-looking ACLs were subjected to mechanical testing and compared
with normal ACLs, the results were less satisfactory. Mechanically, the substituted
ACLs were 45% less stiff than normal ligaments, the yield point was at one-third,
and the ultimate load was 40% of that of a normal ACL (deformation rate, 5 mm/min).
Normal ACLs rupture at their tibial insertion. The transplants ruptured intraligamentarily.
A striking finding was that the substituted ligament did not derotate when all the
other ligamentous and capsular structures were cut. There was no torsional arrangement
of their component bundles. Although the substituted ACL has an excellent histological
and macroscopic appearance, its mechanical properties are inferior.
Key Words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to ArthroscopyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Ligamentous injuries of the canine stiffle joint. A clinical and experimental study.Thesis, Helsinki. 1952;
- Kreuzbandverletzungen im Kniegelenk des Hundes.Thesis, Hannover. 1963; (Verlay M. & M. Schaper.)
- Transposed medial third of patellar ligament in reconstruction of the anterior cruciate ligament. A study in dogs.Acta Chir Scand. 1974;
- A method for replacement of the anterior cruciate ligament of the knee.J Bone Joint Surg. 1963; 45A: 905-924
- Repair and construction of anterior cruciate ligament in dogs.J Bone Joint Surg. 1971; 53A: 710-718
- Fixation of ligamentous structures in the knee: Injuries of ligaments and their repair.in: Chapchal G Georg Thieme, 1977: 90-94
- Das Knie.Springer Verlag, Stuttgart1982
- Biomechanical analysis of human ligament grafts used in knee-ligament repairs and reconstructions.J Bone Joint Surg. 1984; 66A: 344-352
- On interpretation of our anterior cruciate ligament data.Clin Orthop. 1985; 196: 26-31
Article info
Footnotes
*Arthroscopy is pleased to publish this fine article by Dr. van Rens, but is greatly saddened by the news that he passed away on August 9, 1986.
Identification
Copyright
© 1986 Arthroscopy Association of North America. Published by Elsevier Inc.