Effect of Suturing of a Tendon Graft in ACL Reconstruction

Permanent viscoplastic elongation in response to cyclic loading in the early postoperative period might affect a sutured graft function. The objective of this study is to test the hypothesis that suturing of a tendon graft may affect the material properties of the corresponding tendon site, due to local changes in tendon matrix composition. Several digital flexor tendons were armed with a whipstitch and examined under tension or cyclic loading. In parallel a 3D numerical modelling was performed to analyse the mechanical behaviour of the sutured tendon. The experimental data and numerical evaluation show suturing of tendon graft has no significant effect on the mechanical properties of the graft for the application of ACL reconstruction. In general no correlation was found between suturing and the material properties of the tendon segments.