Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 14, Issue 11, pp 1086–1093 | Cite as

The effect of intraosseous graft length on tendon-bone healing in anterior cruciate ligament reconstruction using flexor tendon

  • Shuji Yamazaki
  • Kazunori Yasuda
  • Fumihisa Tomita
  • Akio Minami
  • Harukazu Tohyama


The current study was performed to understand the relationship between graft length placed within the bone tunnel and intraosseous graft healing in anterior cruciate ligament (ACL) reconstruction. Twenty-four adult beagle dogs were divided into two groups of 12 animals each. In each animal, ACL reconstruction using a 4-mm diameter autogenous flexor tendon graft was done in the left knee. In groups I and II, the graft having a length of 15 and 5 mm, respectively, was placed within the tibial tunnel. The proximal end of the graft was placed through the over-the-top route in all animals. In each group, five animals were sacrificed immediately after surgery, and the remaining seven were sacrificed at 6 weeks postoperatively. Biomechanical and histologic evaluations were performed. In pull out testing, the ultimate failure load and the linear stiffness of the graft-tibia complex harvested at 6 weeks were significantly greater than those harvested at the time-zero period. There were no significant differences in those parameters between groups I and II at 6 weeks. In each group, the perpendicular collagen fibers connecting the tendon to the bone tunnel wall were observed only in the narrow area located close to the intra-articular tunnel outlet. In conclusion, excessively long placement of the flexor graft within the bone tunnel does not result in an additional increase of anchoring strength and stiffness of the graft in ACL reconstruction.


Anterior cruciate ligament reconstruction Intraosseous graft length Flexor tendon graft Anchoring strength Intraosseous graft healing 



This work was supported by Grants-in-Aid (Nos.16390425 and 14GS0301) for Scientific Research from the Ministry of Education Culture, Sports, Science, and Technology, Japan.


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Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Shuji Yamazaki
    • 1
  • Kazunori Yasuda
    • 2
  • Fumihisa Tomita
    • 1
  • Akio Minami
    • 1
  • Harukazu Tohyama
    • 2
  1. 1.Department of Orthopaedic SurgeryHokkaido University School of MedicineSapporoJapan
  2. 2.Department of Sports Medicine and Joint Reconstruction SurgeryHokkaido University School of MedicineSapporoJapan

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