Evidence map›Paper›PMID 38373917›Full record

ArticleBMC musculoskeletal disorders2024

Plastic and elastic biomechanical properties of anterior cruciate ligament autografts.

Mason Garcia, Kaveh Momenzadah, Mohammad Javad Shariyate, Nadim Kheir, Mohammad Khak, Juan B Villarreal, Mohammadreza Abbasian, Alexandra F Flaherty, Philip Hanna, Arun Ramappa and 2 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC musculoskeletal disorders, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Mason Garcia *Musculoskeletal Translational Innovation Initiative, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, RN123, Boston, MA, 02115, USA.
Kaveh Momenzadah *Musculoskeletal Translational Innovation Initiative, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, RN123, Boston, MA, 02115, USA.
Mohammad Javad ShariyateMusculoskeletal Translational Innovation Initiative, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, RN123, Boston, MA, 02115, USA.
Nadim KheirMusculoskeletal Translational Innovation Initiative, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, RN123, Boston, MA, 02115, USA.
Mohammad KhakMusculoskeletal Translational Innovation Initiative, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, RN123, Boston, MA, 02115, USA.
Juan B VillarrealMusculoskeletal Translational Innovation Initiative, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, RN123, Boston, MA, 02115, USA.
Mohammadreza AbbasianMusculoskeletal Translational Innovation Initiative, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, RN123, Boston, MA, 02115, USA.
Alexandra F FlahertyOrthopedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, USA.
Philip HannaMusculoskeletal Translational Innovation Initiative, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, RN123, Boston, MA, 02115, USA.
Arun RamappaCarl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Nikolaos K PaschosOrthopedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, USA.
Ara NazarianMusculoskeletal Translational Innovation Initiative, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, RN123, Boston, MA, 02115, USA. anazaria@bidmc.harvard.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAnterior cruciate ligament (ACL) rupture is a common orthopedic injury, occurring in roughly 68.6 per 100,000 persons annually, with the primary treatment option being ACL reconstruction. However, debate remains about the appropriate graft type for restoring the native biomechanical properties of the knee. Furthermore, plastic graft elongation may promote increased knee laxity and instability without rupture. This study aims to investigate the plastic properties of common ACL-R graft options.

methodsPatellar tendon (PT), hamstring tendon (HT), and quadriceps tendon (QT) grafts were harvested from 11 cadaveric knees (6 male and 5 female) with a mean age of 71(range 55-81). All grafts were mechanically tested under uniaxial tension until failure to determine each graft's elastic and plastic biomechanical properties.

resultsMechanically, the QT graft was the weakest, exhibiting the lowest failure force and the lowest failure stress (QT < HT, p = 0.032). The PT was the stiffest of the grafts, having a significantly higher stiffness (PT > QT, p = 0.0002) and Young's modulus (PT > QT, p = 0.001; PT > HT, p = 0.041). The HT graft had the highest plastic elongation at 4.01 ± 1.32 mm (HT > PT, p = 0.002). The post-yield behavior of the HT tendon shows increased energy storage capabilities with the highest plastic energy storage (HT > QT, p = 0.012) and the highest toughness (HT > QT, p = 0.032).

conclusionOur study agrees with prior studies indicating that the failure load of all grafts is above the requirements for everyday activities. However, grafts may be susceptible to yielding before failure during daily activities. This may result in the eventual loss of functionality for the neo-ACL, resulting in increased knee laxity and instability.

Indexed as

Anterior Cruciate Ligament InjuriesPatellar LigamentAgedAnterior Cruciate LigamentAutograftsFemaleHumansKnee JointMaleTransplantation, AutologousAnterior cruciate ligamentAnterior cruciate ligament reconstructionAutograftBiomechanical properties

Identifiers

PMID38373917
PMCPMC10875842

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.