ArticleOrthopaedic journal of sports medicine2025
Correlation of Cerclage Suture With Graft Strength in Quadrupled Soft Tissue Graft Construct in All-Inside Anterior Cruciate Ligament Reconstruction: A Cadaveric Biomechanical Study.
Article in Orthopaedic journal of sports medicine, 2025. 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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Abstract
Background: The all-inside anterior cruciate ligament (ACL) reconstruction technique involves a graft with 2 adjustable loop devices at each end of a closed loop graft, made from folded tendon(s) with cerclage sutures along its length to enhance strength. There is no consensus on the optimal number of cerclage sutures, and this study evaluates their effect on graft strength. Purpose: To establish the effect of the number of cerclage sutures on graft strength. Study Design: Controlled laboratory study. Methods: A controlled cadaveric study of 27 graft specimens was conducted, with specimens standardized to 60 mm in length and 10 mm in diameter and divided into 3 groups: 2-cerclage, 3-cerclage, and 4-cerclage. They were tested using an Instron machine, and data on stiffness, ultimate load to failure (uLTF), and mode of failure were recorded. Results: The 3- and 4-cerclage groups showed no significant difference in stiffness ( Conclusion: A double-tendon 3-cerclage graft matches the stiffness and uLTF of a 4-cerclage graft for diameters ≥10 mm, whereas a 2-cerclage graft appears suboptimal relative to a 3- or 4-cerclage graft. This finding adds to the current literature on all-inside ACL graft techniques. Clinical Relevance: The number of cerclages used in ACL graft preparation may play an important role in optimizing graft tension and stiffness. This potentially contributes to reduction of reinjury risk and a safe return to sports.
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