HOME HELP CONTACT US SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Sign In to gain access to subscriptions and/or personal tools.

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Request Reprints Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Tis, J. E. Articles by Cunningham, B. Search for Related Content PubMed PubMed Citation Articles by Tis, J. E. Articles by Cunningham, B. Related Collections Reconstruction Biomechanics

Braided Hamstring Tendons for Reconstruction of the Anterior Cruciate Ligament

A Biomechanical Analysis

John E. Tis, MAJ, MC USA^*, William R. Klemme, LTC, MC USA^*,,, Kevin L. Kirk, CPT, MC USA^*, Kevin P. Murphy, LTC, MC USA^* and Bryan Cunningham, MS

^* Department of Orthopaedic Surgery, Walter Reed Army Medical Center, Washington, DC, the Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland, Orthopaedic Biomechanics Laboratory, Union Memorial Hospital, Baltimore, Maryland

Address correspondence and reprint requests to LTC William Klemme, USA, 336 Bon Air Center, #388, Greenbrae, CA 94904

Background: In an effort to improve the strength and stiffness of anterior cruciate ligament grafts, several authors have advocated alterations of graft structure and orientation, including braiding the tendons in hamstring tendon grafts.

Hypothesis: Braiding hamstring tendons does not increase graft strength and stiffness.

Study Design: Controlled laboratory study.

Methods: Sixteen hamstring tendon and 21 bone-patellar tendon-bone grafts were harvested from 12 cadavers and divided into three groups: 1) braided four-strand hamstring tendon, 2) unbraided four-strand hamstring tendon, and 3) bone-patellar tendon-bone. All grafts were placed under a 50-N preload on a servohydraulic testing device and were tensioned to failure.

Results: The strength and stiffness of the tested specimens averaged 427 ± 36 N and 76 ± 10 N/mm, respectively, for braided specimens, 532 ± 44 N and 139 ± 18 N/mm for unbraided specimens, and 574 ± 46 N and 158 ± 15 N/mm for patellar tendon specimens. There was a 20% decrement in hamstring tendon graft tensile strength and a 45% decrease in stiffness after braiding because of the suboptimal multidirectional orientation of individual tendons within the braided grafts.

Conclusions: In vitro braided hamstring tendon grafts demonstrated mechanically inferior strength and stiffness characteristics compared with unbraided hamstring tendon grafts and patellar tendon grafts.

Clinical Relevance: Braiding of hamstring tendon grafts provides no mechanical advantage in anterior cruciate ligament reconstruction.

This article has been cited by other articles:

				W. J. Ciccone II, D. R. Bratton, D. M. Weinstein, and J. J. Elias Viscoelasticity and Temperature Variations Decrease Tension and Stiffness of Hamstring Tendon Grafts Following Anterior Cruciate Ligament Reconstruction J. Bone Joint Surg. Am., May 1, 2006; 88(5): 1071 - 1078. [Abstract] [Full Text] [PDF]

				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]