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ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2024

Assessment of formalin preserved and fresh frozen quadriceps tendon graft-suture constructs for load to failure testing: a biomechanical cadaveric study.

Shahbaz S Malik, Darren Hart, Sara Gustafson, Jason Peeler, Sheila McRae, Peter MacDonald

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Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

6 authors.

Shahbaz S MalikWorcestershire Acute Hospital NHS Trusts, Charles Hastings Way, Worcester, WR5 1DD, UK.ORCID http://orcid.org/0000-0001-5272-7410
Darren HartPan Am Clinic Foundation, 75 Poseidon Bay, Winnipeg, MB, R3M 3E4, Canada. dhart4@panamclinic.com.ORCID http://orcid.org/0000-0002-1305-6594
Sara GustafsonOrthopaedic Innovation Centre, 320-1155 Concordia Avenue, Winnipeg, MB, R2K 2M9, Canada.
Jason PeelerMax Rady College of Medicine, University of Manitoba, 102-745 Bannatyne Avenue, Winnipeg, MB, R3E 0J9, Canada.
Sheila McRaePan Am Clinic Foundation, 75 Poseidon Bay, Winnipeg, MB, R3M 3E4, Canada.
Peter MacDonaldPan Am Clinic, 75 Poseidon Bay, Winnipeg, MB, R3M 3E4, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeFresh-frozen specimen availability and cost may be a barrier for initiation of biomechanical studies where soft tissue is used in a construct with other medical devices. The impact of soft tissue preservation method on the outcomes of biomechanical studies in the specific case of graft-suture constructs is relatively unexplored. This study aimed to observe peak loads and failure modes in biomechanical testing of fresh-frozen (FF) versus formalin embalmed (FE) quadriceps tendon (QT) graft-suture constructs for soft tissue fixation in ACLR and assess suitability of FE QT graft constructs for load-to-fail testing.

methodsTwenty QT grafts were harvested from human cadaver specimens. Ten grafts came from fresh-frozen donors and 10 from embalmed donors. All grafts were prepared with the modified Prusik knot using a braided composite suture and subjected to tensile loading. Comparisons between the biomechanical properties of the graft-suture constructs were made with unpaired t tests with α = 0.05.

resultsFE and FF constructs displayed similar peak loads and failure modes. FF constructs had greater elongation after pre-tensioning than FE (7.3 vs. 5.5 mm, p = 0.02) and greater elongation after cyclic loading than FE constructs (17.5 vs. 10.5 mm, p = 0.01). Hysteresis was greater for FF constructs at the 50th, 100th, 150th, and 200th cycle (p = 0.02, p = 0.07, p < 0.001, p = 0.004, respectively). FE constructs were stiffer than fresh-frozen (103 vs. 84 N/mm, p < 0.001).

conclusionFE constructs were significantly stiffer but displayed similar peak load and failure mode to FF which was reflective of the strength of the suture material. FE grafts can offer an alternative to FF grafts in graft-suture constructs for biomechanical studies where load at failure and knot security and strength is of main interest.

Indexed as

CadaverFormaldehydeTendonsTensile StrengthBiomechanical PhenomenaCryopreservationEmbalmingFixativesHumansMaleMaterials TestingQuadriceps MuscleSuturesSuture TechniquesWeight-BearingFixativesFormaldehydeAnterior cruciate ligamentEmbalmedFresh frozenLoad-to-failureModified Prusik knotQuadriceps tendon

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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.