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Fractionation of high-dose electron beam irradiation of BPTB grafts provides significantly improved viscoelastic and structural properties compared to standard gamma irradiation

  • Experimental Study
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Irradiation >30 kGy is required to achieve sterility against bacterial and viral pathogens in ACL allograft sterilization. However, doses >20 kGy substantially reduce the structural properties of soft-tissue grafts. Fractionation of irradiation doses is a standard procedure in oncology to reduce tissue damage but has not been applied in tissue graft sterilization.

Methods

Forty-four human 10-mm wide bone-patellar-tendon-bone grafts were randomized into four groups of sterilization with (1) 34 kGy of ebeam (2) 34 kGy gamma (3) 34 kGy fractionated ebeam, and (4) non sterilized controls. Graft´s biomechanical properties were evaluated at time zero. Biomechanical properties were analyzed during cyclic and load-to-failure testing.

Results

Fractionation of ebeam irradiation resulted in significantly higher failure loads (1,327 ± 305) than with one-time ebeam irradiation (1,024 ± 204; P = 0.008). Compared to gamma irradiation, significantly lower strain (2.9 ± 1.5 vs. 4.6 ± 2.0; P = 0.008) and smaller cyclic elongation response (0.3 ± 0.2 vs. 0.6 ± 0.4; P = 0.05), as well as higher failure loads (1,327 ± 305 vs. 827 ± 209; P = 0.001), were found. Compared to non-irradiated BPTB grafts, no significant differences were found for any of the biomechanical parameters. Non-irradiated controls had significantly lower cyclic elongation response and higher failure loads than ebeam and gamma irradiation.

Conclusions

In this study, it was found that fractionation of high-dose electron beam irradiation facilitated a significant improvement of viscoelastic and structural properties of BPTB grafts compared to ebeam and gamma irradiation alone, while maintaining levels of non-irradiated controls. Therefore, this technique might pose an important alternative to common methods for sterilization of soft-tissue allografts.

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Authors and Affiliations

  1. Sports Medicine and Arthroscopy Service, Hospital for Orthopaedic Surgery and Traumatology, Campus Mitte, Charité, University Medicine Berlin, Charité Platz 1, 10117, Berlin, Germany

    A. Hoburg, C. Perka & S. Scheffler

  2. Institute for Transfusion Medicine (Tissue Bank), Charité, University Medicine Berlin, Berlin, Germany

    S. Keshlaf & A. Pruss

  3. Julius Wolff Institue, University Medicine Berlin, Augustenburger Platz 1, 13353, Berlin, Germany

    T. Schmidt

  4. German Institute for Cell and Tissue Replacement (DIZG), Berlin, Germany

    M. Smith

  5. Leibniz-Institute of Polymer Research Dresden, Hohe Straße 6, 01069, Dresden, Germany

    U. Gohs

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  1. A. Hoburg
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  2. S. Keshlaf
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  3. T. Schmidt
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  4. M. Smith
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  5. U. Gohs
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  6. C. Perka
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  7. A. Pruss
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  8. S. Scheffler
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Correspondence to A. Hoburg.

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Hoburg, A., Keshlaf, S., Schmidt, T. et al. Fractionation of high-dose electron beam irradiation of BPTB grafts provides significantly improved viscoelastic and structural properties compared to standard gamma irradiation. Knee Surg Sports Traumatol Arthrosc 19, 1955–1961 (2011). https://doi.org/10.1007/s00167-011-1518-9

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  • DOI: https://doi.org/10.1007/s00167-011-1518-9

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