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In Vitro Structural Properties of Braided Tendon Grafts

Orthopaedic Research Laboratory, Prince of Wales Hospital, University of New South Wales, Randwick, Australia

* Address correspondence and reprint requests to William R. Walsh, PhD, Orthopaedic Research Laboratory, Prince of Wales Hospital, Edmund Blacket Building, University of New South Wales, High Street, Randwick, NSW 2031, Australia

In an effort to increase strength in hamstring tendon grafts for anterior cruciate ligament reconstruction, braiding or weaving of the tendons has been suggested. The purpose of this study was to examine the biomechanical properties of two braiding techniques compared with a four-stranded tendon graft using a sheep model. Digital extensor tendons from 5 adult sheep were harvested in 28 matched pairs and randomly allocated to French plait or four-stranded weave. The grafts were tested in a hydraulic testing machine with the tendons secured in brass grips frozen with liquid carbon dioxide. The tendons were preconditioned to a distraction of 1 mm for 10 cycles followed by testing to failure at 50 mm/sec, with a data acquisition rate of 1000 Hz. The stiffness, ultimate load to failure, and the mode of failure were recorded. All braided samples failed at the midsubstance, while the four-stranded controls failed at the grip interface. There was a significant reduction in strength and stiffness of the braided samples compared with the controls. This study demonstrated that braiding decreases the strength and stiffness of a four-stranded tendon graft by up to 54% and 85%, respectively. This finding is supported by the work of Hearle et al. (1969), who demonstrated that the decrease in strength of fiber bundles is equal to the square of the cosine of the twist angle. The twist angle in our samples was approximately 45°, which equates to a decrease in strength of 50%.

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				D. H. Kim, D. R. Wilson, A. T. Hecker, T. M. Jung, and C. H. Brown Jr. Twisting and Braiding Reduces the Tensile Strength and Stiffness of Human Hamstring Tendon Grafts Used for Anterior Cruciate Ligament Reconstruction Am. J. Sports Med., November 1, 2003; 31(6): 861 - 867. [Abstract] [Full Text] [PDF]

				P. J. Millett, B. S. Miller, M. Close, W. I. Sterett, W. Walsh, and R. J. Hawkins Effects of Braiding on Tensile Properties of Four-Strand Human Hamstring Tendon Grafts Am. J. Sports Med., September 1, 2003; 31(5): 714 - 717. [Abstract] [Full Text] [PDF]

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