Análise do comportamento mecânico de um modelo animal de configuração de enxerto de trança tripla de isquiotibiais para reconstrução combinada de LCA e LAL para túnel único femoral

Abstract

Combined reconstruction of the anterior cruciate ligament (ACL) and the anterolateral ligament (ALL) of the knee has shown excellent results in specific patient groups. This could potentially reduce graft failure and improve outcomes in high-risk patients. The aim of this study is to describe and mechanically test a configuration in an animal model that simulates the triple hamstring graft for combined ACL and ALL reconstruction with a single femoral tunnel and a single strand for ALL reconstruction. Deep flexor porcine tendons were used as graft and fixed with titanium interference screws in a polyurethane block. The samples were divided into three groups: Group 1 (control) with quadruple graft; Group 2 with simple triple graft; and Group 3 with braided triple graft. The tests were conducted using an EMIC DL 10000 electromechanical universal testing machine. The samples in Groups 1, 2, and 3 obtained peak forces of 816.28 ± 78.78 N, 506.95 ± 151.30 N, and 723.16 ± 316.15 N, respectively. In Group 3, braiding increased graft diameter by 9-14% and caused a shortening of 4-8% compared to Group 1, with an average peak force increase of about 200 N (p < 0.05). Regarding peak forces, there was no statistically significant difference between Groups 1 and 3, indicating that quadruple and braided triple grafts showed similar strength results. Therefore, we conclude that the triple braided hamstring graft configuration for combined ACL and ALL reconstruction with a single femoral tunnel and a single strand for ALL reconstruction may become a mechanically viable solution with potential clinical application.