Human patellar tendon stiffness is restored following graft harvest for anterior cruciate ligament surgery |
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| Authors: | Neil D Reeves Constantinos N Maganaris Nicola Maffulli Joern Rittweger |
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| Institution: | 1. Institute for Biomedical Research into Human Movement and Health, Manchester Metropolitan University, John Dalton Building, Oxford Road, Manchester, UK;2. Centre for Sports and Exercise Medicine, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, Mile End Hospital, 275 Bancroft Road, London, UK;1. Neurosurgery Department, Regional Specialist Hospital, Olsztyn, Poland;2. Neurosurgery Department, Medical University of Gdańsk, Gdańsk, Poland;3. Department of Molecular Pathology and Neuropathology, Medical University of ?ód?, Poland;4. Department of Preventive Medicine and Education, Medical University of Gdańsk, Gdańsk, Poland;5. Neurosurgery and CNS Oncology Department, Medical University of ?ód?, Poland;1. School of Occupational Therapy, National Taiwan University, Taipei City, Taiwan, ROC;2. Department of Physical Medicine and Rehabilitation, Taoyuan Armed Forces General Hospital, Taoyuan County, Taiwan, ROC;3. Department of Physical Medicine and Rehabilitation, Shin Kong Wu Ho-Su Memorial Hospital, Taipei City, Taiwan, ROC;4. Graduate Institute of Biomedical Engineering, National Taiwan University of Science and Technology, Taipei City, Taiwan, ROC;5. Institute of Biomedical Engineering, National Taiwan University, Taipei City, Taiwan, ROC;6. Department of Orthopaedic Surgery, School of Medicine, National Taiwan University, Taipei City, Taiwan, ROC;7. School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan, ROC;1. Eastern Virginia Medical School, Norfolk, Virginia, U.S.A.;2. Jordan-Young Institute for Orthopedic Surgery & Sports Medicine, Virginia Beach, Virginia, U.S.A.;3. LifeNet Health, Virginia Beach, Virginia, U.S.A.;1. Institute of Orthopedics and Traumatology of the Clinical Hospital, Medical School, University of Sao Paulo, Sao Paulo, Brazil;2. Medical School, University of Sao Paulo, Sao Paulo, Brazil;1. Biomechanics Laboratory, Department of Kinesiology, The Pennsylvania State University, University Park, PA 16802, USA;2. Department of Mechanical Engineering, The Pennsylvania State University, University Park, PA 16802, USA |
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| Abstract: | Minimising post-operative donor site morbidity is an important consideration when selecting a graft for surgical reconstruction of the torn anterior cruciate ligament (ACL). One of the most common procedures, the bone-patellar tendon-bone (BPTB) graft involves removal of the central third from the tendon. However, it is unknown whether the mechanical properties of the donor site (patellar tendon) recover. The present study investigated the mechanical properties of the human patellar tendon in 12 males (mean±S.D. age: 37±14 years) who had undergone surgical reconstruction of the ACL using a BPTB graft between 1 and 10 years before the study (operated knee; OP). The uninjured contralateral knee served as a control (CTRL). Patellar tendon mechanical properties were assessed in vivo combining dynamometry with ultrasound imaging. Patellar tendon stiffness was calculated from the gradient of the tendon's force–elongation curve. Tendon stiffness was normalised to the tendon's dimensions to obtain the tendon's Young's modulus. Cross-sectional area (CSA) of OP patellar tendons was larger by 21% than CTRL tendons (P<0.01). Patellar tendon stiffness was not significantly different between OP and CTRL tendons, but the Young's modulus was lower by 24% in OP tendons (P<0.01). A compensatory enlargement of the patellar tendon CSA, presumably due to scar tissue formation, enabled a recovery of tendon stiffness in the OP tendons. The newly formed tendon tissue had inferior properties as indicated by the reduced tendon Young's modulus, but it increased to a level that enabled recovery of tendon stiffness. |
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