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J Knee Surg 2015; 28(06): 489-495
DOI: 10.1055/s-0034-1390331
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

A Novel Small Animal Model of Differential Anterior Cruciate Ligament Reconstruction Graft Strain

Richard Ma
1   Sports Medicine and Shoulder Surgery Service, Hospital for Special Surgery, New York, New York
2   Missouri Orthopaedic Institute, University of Missouri, Columbia, Missouri
,
Xiaodong Ju
3   Institute of Sports Medicine, The Third Affiliated Hospital, Peking University, Beijing, China
,
Xiang-Hua Deng
1   Sports Medicine and Shoulder Surgery Service, Hospital for Special Surgery, New York, New York
,
Scott A. Rodeo
1   Sports Medicine and Shoulder Surgery Service, Hospital for Special Surgery, New York, New York
› Author Affiliations
Further Information

Publication History

23 January 2014

12 August 2014

Publication Date:
24 October 2014 (online)

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Abstract

The aim of the study was to establish a small animal research model of anterior cruciate ligament (ACL) reconstruction where ACL graft force can be predictably altered with knee motion. Cadaveric rat knees (n = 12) underwent ACL resection followed by reconstruction. Six knees received anterior (high-tension) femoral graft tunnels and six knees received posterior (isometric) graft tunnels. All the 12 knees and ACL grafts were pretensioned to 3 N at 15 or 45 degrees of knee flexion. ACL graft force (N) was recorded as the knee was ranged from extension to 90-degree flexion. Distinct ACL graft force patterns were generated for a high-tension and isometric femoral graft tunnels. For a high-tension femoral tunnel, the rat ACL graft remained relatively isometric at lower knee flexion angles but increased as the knee was flexed beyond 45 degrees. At 90 degrees, high-tension grafts had significantly greater mean graft tension for both pretensioning at 15 degrees (5.58 ± 1.34 N, p = 0.005) and 45 degrees (6.35 ± 1.24 N, p = 0.001). In contrast, the graft forces for isometric ACL grafts remained relatively constant with knee flexion. Compared with a high-tension ACL grafts, the graft force for grafts placed in an isometric tunnel had significantly lower ACL graft forces at 60, 75, and 90 degrees of knee flexion for both pretensioning at 15 and 45 degrees, respectively. We were able to demonstrate that ACL graft forces in our rat model of ACL reconstruction were sensitive to femoral tunnel position similar to human knees. We were also able to establish two reproducible femoral graft tunnel positions in this small animal model, which yielded significantly different ACL graft tension patterns with knee range of motion. This model would permit further research on how ACL graft tension may affect graft healing.

Keywords

ACL graft strain - ACL isometry - ACL tunnel position
 

  • References

  • 1 Bedi A, Kovacevic D, Fox AJ , et al. Effect of early and delayed mechanical loading on tendon-to-bone healing after anterior cruciate ligament reconstruction. J Bone Joint Surg Am 2010; 92 (14) 2387-2401
    CrossrefPubMedGoogle Scholar
  • 2 Brophy RH, Kovacevic D, Imhauser CW , et al. Effect of short-duration low-magnitude cyclic loading versus immobilization on tendon-bone healing after ACL reconstruction in a rat model. J Bone Joint Surg Am 2011; 93 (4) 381-393
    CrossrefPubMedGoogle Scholar
  • 3 Rodeo SA, Kawamura S, Kim HJ, Dynybil C, Ying L. Tendon healing in a bone tunnel differs at the tunnel entrance versus the tunnel exit: an effect of graft-tunnel motion?. Am J Sports Med 2006; 34 (11) 1790-1800
    CrossrefPubMedGoogle Scholar
  • 4 Thomopoulos S, Williams GR, Soslowsky LJ. Tendon to bone healing: differences in biomechanical, structural, and compositional properties due to a range of activity levels. J Biomech Eng 2003; 125 (1) 106-113
    CrossrefPubMedGoogle Scholar
  • 5 Thomopoulos S, Zampiakis E, Das R, Silva MJ, Gelberman RH. The effect of muscle loading on flexor tendon-to-bone healing in a canine model. J Orthop Res 2008; 26 (12) 1611-1617
    CrossrefPubMedGoogle Scholar
  • 6 Thornton GM, Shao X, Chung M , et al. Changes in mechanical loading lead to tendon specific alterations in MMP and TIMP expression: influence of stress deprivation and intermittent cyclic hydrostatic compression on rat supraspinatus and Achilles tendons. Br J Sports Med 2010; 44 (10) 698-703
    CrossrefPubMedGoogle Scholar
  • 7 Marchant BG, Noyes FR, Barber-Westin SD, Fleckenstein C. Prevalence of nonanatomical graft placement in a series of failed anterior cruciate ligament reconstructions. Am J Sports Med 2010; 38 (10) 1987-1996
    CrossrefPubMedGoogle Scholar
  • 8 Trojani C, Sbihi A, Djian P , et al. Causes for failure of ACL reconstruction and influence of meniscectomies after revision. Knee Surg Sports Traumatol Arthrosc 2011; 19 (2) 196-201
    CrossrefPubMedGoogle Scholar
  • 9 Bylski-Austrow DI, Grood ES, Hefzy MS, Holden JP, Butler DL. Anterior cruciate ligament replacements: a mechanical study of femoral attachment location, flexion angle at tensioning, and initial tension. J Orthop Res 1990; 8 (4) 522-531
    CrossrefPubMedGoogle Scholar
  • 10 Lewis JL, Lew WD, Engebretsen L, Hunter RE, Kowalczyk C. Factors affecting graft force in surgical reconstruction of the anterior cruciate ligament. J Orthop Res 1990; 8 (4) 514-521
    CrossrefPubMedGoogle Scholar
  • 11 Markolf KL, Hame S, Hunter DM , et al. Effects of femoral tunnel placement on knee laxity and forces in an anterior cruciate ligament graft. J Orthop Res 2002; 20 (5) 1016-1024
    CrossrefPubMedGoogle Scholar
  • 12 Melhorn JM, Henning CE. The relationship of the femoral attachment site to the isometric tracking of the anterior cruciate ligament graft. Am J Sports Med 1987; 15 (6) 539-542
    CrossrefPubMedGoogle Scholar
  • 13 Penner DA, Daniel DM, Wood P, Mishra D. An in vitro study of anterior cruciate ligament graft placement and isometry. Am J Sports Med 1988; 16 (3) 238-243
    CrossrefPubMedGoogle Scholar
  • 14 Zavras TD, Race A, Amis AA. The effect of femoral attachment location on anterior cruciate ligament reconstruction: graft tension patterns and restoration of normal anterior-posterior laxity patterns. Knee Surg Sports Traumatol Arthrosc 2005; 13 (2) 92-100
    CrossrefPubMedGoogle Scholar
  • 15 Mae T, Shino K, Matsumoto N, Maeda A, Nakata K, Yoneda M. Graft tension during active knee extension exercise in anatomic double-bundle anterior cruciate ligament reconstruction. Arthroscopy 2010; 26 (2) 214-222
    CrossrefPubMedGoogle Scholar
  • 16 Murray PJ, Alexander JW, Gold JE, Icenogle KD, Noble PC, Lowe WR. Anatomic double-bundle anterior cruciate ligament reconstruction: kinematics and knee flexion angle-graft tension relation. Arthroscopy 2010; 26 (2) 202-213
    CrossrefPubMedGoogle Scholar
  • 17 Yasuda K, Ichiyama H, Kondo E, Miyatake S, Inoue M, Tanabe Y. An in vivo biomechanical study on the tension-versus-knee flexion angle curves of 2 grafts in anatomic double-bundle anterior cruciate ligament reconstruction: effects of initial tension and internal tibial rotation. Arthroscopy 2008; 24 (3) 276-284
    CrossrefPubMedGoogle Scholar
  • 18 Hildebrand C, Oqvist G, Brax L, Tuisku F. Anatomy of the rat knee joint and fibre composition of a major articular nerve. Anat Rec 1991; 229 (4) 545-555
    CrossrefPubMedGoogle Scholar
  • 19 Lubowitz JH. Anatomic ACL reconstruction produces greater graft length change during knee range-of-motion than transtibial technique. Knee Surg Sports Traumatol Arthrosc 2014; 22 (5) 1190-1195
    CrossrefPubMedGoogle Scholar
  • 20 Wang JH, Kato Y, Ingham SJ , et al. Measurement of the end-to-end distances between the femoral and tibial insertion sites of the anterior cruciate ligament during knee flexion and with rotational torque. Arthroscopy 2012; 28 (10) 1524-1532
    CrossrefPubMedGoogle Scholar
  • 21 Bedi A, Musahl V, Steuber V , et al. Transtibial versus anteromedial portal reaming in anterior cruciate ligament reconstruction: an anatomic and biomechanical evaluation of surgical technique. Arthroscopy 2011; 27 (3) 380-390
    CrossrefPubMedGoogle Scholar
  • 22 Musahl V, Voos JE, O'Loughlin PF , et al. Comparing stability of different single- and double-bundle anterior cruciate ligament reconstruction techniques: a cadaveric study using navigation. Arthroscopy 2010; 26 (9, Suppl): S41-S48
    CrossrefPubMedGoogle Scholar
  • 23 Yagi M, Wong EK, Kanamori A, Debski RE, Fu FH, Woo SL. Biomechanical analysis of an anatomic anterior cruciate ligament reconstruction. Am J Sports Med 2002; 30 (5) 660-666
    CrossrefPubMedGoogle Scholar
  • 24 Kato Y, Ingham SJ, Kramer S, Smolinski P, Saito A, Fu FH. Effect of tunnel position for anatomic single-bundle ACL reconstruction on knee biomechanics in a porcine model. Knee Surg Sports Traumatol Arthrosc 2010; 18 (1) 2-10
    CrossrefPubMedGoogle Scholar