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Sports Medicine Service and Department of Biomechanics, The Hospital for Special Surgery, Cornell University Medical College, New York, New York
Sports Medicine Service and Department of Biomechanics, The Hospital for Special Surgery, Cornell University Medical College, New York, New York
Sports Medicine Service and Department of Biomechanics, The Hospital for Special Surgery, Cornell University Medical College, New York, New York
Sports Medicine Service and Department of Biomechanics, The Hospital for Special Surgery, Cornell University Medical College, New York, New York
Thirty-seven bone-patellar tendon-bone composite grafts from the knees of 21 human cadavers were tested to failure. Average donor age was 28 years. The composites were divided into 4 groups: 3 groups with 10 grafts (5 pairs) and 1 group with 7 grafts from 6 donors. In Group 1 we tested 10- versus 15-mm wide grafts that were used without twisting; Group II, 10- mm wide grafts without twisting versus 10-mm wide grafts that were twisted 90°; Group III, 10-mm wide grafts twisted 90° versus 10-mm wide grafts twisted 180°; and Group IV, 10- versus 7-mm wide grafts that were not twisted. The tests were performed using a newly described potting technique and clamp system and a servohydraulic testing machine with an elongation rate of 5 cm/sec.
The results of this study suggest that the central third of the patellar tendon is stronger than previously re ported. The mean ultimate load of a 15-mm bone- patellar tendon-bone composite was 4389 N (±708); of the 10-mm wide composites, 2977 N (±516); and of the 7-mm composites, 2238 N (±316). Twisting the graft 90° increased the strength (P < 0.05). Further twisting to 180° had no significant effect compared with twisting 90°. This study supports the practice of using smaller (10 mm) bone-patellar tendon-bone grafts to avoid the potential complications of patellar fracture and graft impingement in the notch.
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