Functional evaluation of anterior cruciate ligagment autografts in pre-clinical animal models
Communication sans acte
Introduction Rupture of the Anterior Cruciate Ligament (ACL) affects about 1 person over 3000 every year. The current standard care is based on ligament reconstruction by autograft from tendon tissues and is considered as the gold standard. Yet, autograft reconstruction presents serious limitations. Recent developments in artificial ligaments are promising and could potentially address the currently growing demand from surgeons and patients for an off-the-shelf alternate solution. However, before these can be commonly used in clinical routine, their biocompatibility and biomechanical performance for the short and long terms must be studied in pre-clinical animal models. Building upon the work of , we propose in this contribution a methodology for assessing the biomechanical performance of artificial ligaments, and to provide reference data (autografts) using an animal model (sheep) at 3 months after implantation. Materials and Methods Surgery and specimen preparation 14 fresh frozen lower limbs were used in this study, seven left (autograft implantation) and seven right (contralateral) knees. These were harvested from seven sheep sacrificed 3 months after implantation. The biomechanical analysis of the knees consisted of four successive in vitro experiments: three kinematics tests (flexion-extension, varus-valgus laxity and anterior drawer tests) and a pull-out destructive test. Kinematics analysis: flexion-extension and laxity tests The kinematic analysis was performed using specific motorized devices adapted from previously described and validated ones . The protocol combined motion analysis of tripods screwed in the bony structures and 3D personalized reconstruction (figure 1) from low-dose X-ray system (EOS, EOS Imaging, Paris, France) [1,2,3,4]. Pull-out destructive tests The pull-out tests were performed using an INSTRON 5566 testing machine (Instron Ltd., Buckingham-shire, England) instrumented with a 5 kN load cell. After conditioning, a tension load was applied to the specimen (5 mm/min) until total failure. Data analysis: mobility assessment and statistical tests The following parameters were extracted to allow the comparison with the literature  (i) Internal rotation Ry (°) value for a 40° flexion angle (Ry_40), (ii) Anterior Tibial Translation (mm) for 100 N loading (ATT_100), (iii) Varus Valgus amplitude (°) at 4 Nm loading (VV_4) and (iv) the Failure load (N) (FL). Results and discussion The results shows a good consistency for kinematic parameters of the contralateral knees. The failure load was clearly different due to the interindividual variability. As concerns the autograft, a reduction of internal rotation during the flexion motion and an increase of the laxity in ATT could be observed. The failure load was also decreased for the grafted knee.
Files in this item
Showing items related by title, author, creator and subject.
Article dans une revue avec comité de lectureMAEZTU REDIN, Deyo; CAROUX, Julien; ROHAN, Pierre Yves; PILLET, Hélène; CERMOLACCE, Alexia; TRNKA, Julien; MANASSERO, Mathieu; VIATEAU, Véronique; CORTÉ, Laurent (Elsevier BV, 2022-09)Impingement with surrounding tissues is a major cause of failure of anterior cruciate ligament reconstruction. However, the complexity of the knee kinematics and anatomical variations make it difficult to predict the ...
Combined 3D analysis of lower-limb morphology and function in children with idiopathic equinovarus clubfoot: A preliminary study Article dans une revue avec comité de lectureRAMPAL, Virginie; ROHAN, Pierre-Yves; PILLET, Hélène; BONNET-LEBRUN, Aurore; FONESCA, Mickael; DESAILLY, Eric; WICART, Philippe; SKALLI, Wafa (Elsevier Masson, 2020)Introduction In children treated for idiopathic equinovarus clubfoot (EVCF), the relation between morphologic defects on clinical examination and standard X-ray on the one hand and functional abnormalities on the other is ...
Role of Ligaments in the Knee Joint Kinematic Behavior: Development and Validation of a Finite Element Model Chapitre d'ouvrage scientifiqueGERMAIN, François; ROHAN, Pierre-Yves; ROCHCONGAR, Goulven; ROUCH, Philippe; THOREUX, Patricia; PILLET, Hélène; SKALLI, Wafa (Springer International Publishing, 2016)The management of knee instability is a complex problem in orthopedic surgery. To comprehensively assess the biomechanical role of the knee joint and to investigate various aspects of knee mechanics, several Finite Element ...
Development and evaluation of a new procedure for subject-specific tensioning of finite element knee ligaments Article dans une revue avec comité de lectureLAHKAR, Bhrigu K.; ROHAN, Pierre-Yves; PILLET, Helene; THOREUX, Patricia; SKALLI, Wafa (Taylor and Francis, 2021)Subject-specific tensioning of ligaments is essential for the stability of the knee joint and represents a challenging aspect in the development of finite element models. We aimed to introduce and evaluate a new procedure ...
Reliability of B-mode ultrasound and shear wave elastography in evaluating sacral bone and soft tissue characteristics in young adults with clinical feasibility in elderly Article dans une revue avec comité de lectureABOU KARAM, Maher; MUKHINA, Ekaterina; DARAS, Nils; RIVALS, ISabelle; PILLET, Helene; SKALLI, Wafa; CONNESSON, Nathanael; PAYAN, Yohan; ROHAN, PIerre-Yves (2022)Background: Physiologic aging is associated with loss of mobility, sarcopenia, skin atrophy and loss of elasticity. These factors contribute, in the elderly, to the occurrence of a pressure ulcer (PU). Brightness mode ...