A biomechanical comparison of fan-folded, single-looped fascia lata with other graft tissues as a suitable substitute for anterior cruciate ligament reconstruction

Daniel B. Chan, H. Thomas Temple, Loren L. Latta, Siddharth Mahure, Jeremy Dennis, Lee Kaplan

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Purpose: The purpose of this study was to evaluate the initial biomechanical properties of a fan-folded, single-loop construct of fan-folded fascia lata allograft in comparison to other graft tissues currently being used for anterior cruciate ligament (ACL) reconstruction. Methods: Eighteen fascia lata specimens were harvested from 11 donors and fan folded through a proprietary process. Bonepatellar tendonbone (BPTB), tibialis anterior, tibialis posterior, and peroneus longus tendons were harvested from 4 additional donors. All soft-tissue grafts were tested to failure in an MTS machine (MTS Systems, Eden Prairie, MN) in a single-looped fashion. BPTB grafts were similarly clamped in freeze grips. The ultimate load to failure and stiffness were calculated for each graft type tested. Results: The mean ultimate load to failure was 3,266 N and stiffness was 414 N/mm for the single-looped fascia lata grafts (n = 18). There was no significant difference for ultimate load to failure and stiffness between the fascia lata and tibialis anterior (3,012 N and 342 N/mm, respectively), tibialis posterior (3,666 N and 392 N/mm, respectively), and peroneus longus (3,050 N and 346 N/mm, respectively) tendons. The fascia lata grafts performed significantly better (P < .001) than BPTB (1,404 N and 224 N/mm, respectively). Conclusions: A single-loop construct of fan-folded fascia lata allograft has, on biomechanical testing, initial ultimate tensile strength (3,266 N) and stiffness values equivalent to or better than several other graft tissues currently used in ACL reconstruction, including BPTB (1,403 N), tibialis anterior (3,012 N), tibialis posterior (3,666 N), and peroneus longus (3,050 N). Clinical Relevance: In the face of potential allograft tissue shortages and increasing constraints on health care expenditures, the use of fascia lata has the potential to be a readily available graft for ACL reconstruction that performs as well as other grafts and at a comparable or lower cost.

Original languageEnglish
JournalArthroscopy - Journal of Arthroscopic and Related Surgery
Volume26
Issue number12
DOIs
StatePublished - Dec 1 2010

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Fascia Lata
Anterior Cruciate Ligament Reconstruction
Transplants
Allografts
Tendons
Tensile Strength
Hand Strength
Health Expenditures
Delivery of Health Care
Costs and Cost Analysis

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

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A biomechanical comparison of fan-folded, single-looped fascia lata with other graft tissues as a suitable substitute for anterior cruciate ligament reconstruction. / Chan, Daniel B.; Thomas Temple, H.; Latta, Loren L.; Mahure, Siddharth; Dennis, Jeremy; Kaplan, Lee.

In: Arthroscopy - Journal of Arthroscopic and Related Surgery, Vol. 26, No. 12, 01.12.2010.

Research output: Contribution to journalArticle

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abstract = "Purpose: The purpose of this study was to evaluate the initial biomechanical properties of a fan-folded, single-loop construct of fan-folded fascia lata allograft in comparison to other graft tissues currently being used for anterior cruciate ligament (ACL) reconstruction. Methods: Eighteen fascia lata specimens were harvested from 11 donors and fan folded through a proprietary process. Bonepatellar tendonbone (BPTB), tibialis anterior, tibialis posterior, and peroneus longus tendons were harvested from 4 additional donors. All soft-tissue grafts were tested to failure in an MTS machine (MTS Systems, Eden Prairie, MN) in a single-looped fashion. BPTB grafts were similarly clamped in freeze grips. The ultimate load to failure and stiffness were calculated for each graft type tested. Results: The mean ultimate load to failure was 3,266 N and stiffness was 414 N/mm for the single-looped fascia lata grafts (n = 18). There was no significant difference for ultimate load to failure and stiffness between the fascia lata and tibialis anterior (3,012 N and 342 N/mm, respectively), tibialis posterior (3,666 N and 392 N/mm, respectively), and peroneus longus (3,050 N and 346 N/mm, respectively) tendons. The fascia lata grafts performed significantly better (P < .001) than BPTB (1,404 N and 224 N/mm, respectively). Conclusions: A single-loop construct of fan-folded fascia lata allograft has, on biomechanical testing, initial ultimate tensile strength (3,266 N) and stiffness values equivalent to or better than several other graft tissues currently used in ACL reconstruction, including BPTB (1,403 N), tibialis anterior (3,012 N), tibialis posterior (3,666 N), and peroneus longus (3,050 N). Clinical Relevance: In the face of potential allograft tissue shortages and increasing constraints on health care expenditures, the use of fascia lata has the potential to be a readily available graft for ACL reconstruction that performs as well as other grafts and at a comparable or lower cost.",
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AU - Mahure, Siddharth

AU - Dennis, Jeremy

AU - Kaplan, Lee

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