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Biomechanical evaluation of augmented and nonaugmented primary repair of the anterior cruciate ligament: an in vivo animal study

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Abstract

Purpose

The purpose of this study was to evaluate in a sheep model the biomechanical performance of augmented and nonaugmented primary repair of the anterior cruciate ligament (ACL) following transection at the femoral end during a 12-month postoperative observation.

Methods

Forty sheep were randomly assigned to nonaugmented or augmented primary ACL repair using a polyethylene terephthalate (PET) band. At two, six, 16, 26 and 52 weeks postoperatively four sheep in each group were sacrificed and biomechanical testing performed.

Results

Compared with nonaugmented primary ACL repair, the PET-augmented repair demonstrated superior biomechanical results from 16 weeks postoperatively onwards in terms of anterioposterior (AP) laxity, tensile strength and ligament stiffness. The augmentation device works as a stress shield during the ligament healing process. The nonaugmented ACL repair also resulted in ligament healing, but the biomechanical properties were at a significantly lower level.

Conclusion

These results support the previously reported histological findings following augmented primary ACL repair. This animal study on the healing capacity of the ACL may provide some important contributions to how primary healing in certain types of ruptures can be achieved.

Clinical relevance

I

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Acknowledgments

The study was funded by the Austrian Research Fund (P09827-MED) and the Scientific Fund of the Major of Vienna.

Conflict of interest

None.

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Authors and Affiliations

  1. Department of Trauma Surgery, Medical University of Graz, Auenbruggerplatz, Graz, Austria

    Helmut Seitz

  2. Department of Physics of Functional Materials, University of Vienna, Strudlhofgasse 4, Vienna, Austria

    Wofgang Pichl

  3. Department of Surgery, Division of Thoracic and Hyperbaric Surgery, Medical University of Graz, Graz, Austria

    Veronika Matzi

  4. Ludwig Boltzmann Institute of Experimental and Clinical Traumatology, Donaueschingenstrasse 13, Vienna, Austria

    Thomas Nau

  5. The Austrian Cluster for Tissue Engineering, Vienna, Austria

    Thomas Nau

  6. IMSART, Institute for Musculoskeletal Analysis Research and Therapy, Piaristengasse 2-4, Vienna, Austria

    Thomas Nau

Authors
  1. Helmut Seitz
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  2. Wofgang Pichl
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  3. Veronika Matzi
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  4. Thomas Nau
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Corresponding author

Correspondence to Thomas Nau.

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Seitz, H., Pichl, W., Matzi, V. et al. Biomechanical evaluation of augmented and nonaugmented primary repair of the anterior cruciate ligament: an in vivo animal study. International Orthopaedics (SICOT) 37, 2305–2311 (2013). https://doi.org/10.1007/s00264-013-2098-8

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  • DOI: https://doi.org/10.1007/s00264-013-2098-8

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