Biomechanical Analysis of Antibiotic-Treated Tendon Grafts With Digital Image Correlation: A Comparison Between Vancomycin, Gentamycin, and Tobramycin Soaking Techniques.

Tensile strength comparison between hamstring tendon, patellar tendon, quadriceps tendon and peroneus longus tendon: A cadaver research

Tendon graft soaking in vancomycin solution minimizes surgical infection risk and has no effect on graft strength, but the intermittent vancomycin shortages, presence of vancomycin-resistant organisms, and treatment needs of patients with vancomycin hypersensitivity merit investigation of alternative antibiotics. Tobramycin prevents infection at low concentrations and is a cost-effective alternative, but it is unknown if tobramycin alters graft mechanical properties. The purpose of this study was to investigate the effects of tobramycin soaking on tendon graft mechanical properties. It was hypothesized that tobramycin soaking will not affect tendon graft mechanical properties. Controlled laboratory study. A total of 30 tibialis tendon grafts were wrapped in saturated gauze swabs containing saline (control; n = 10), vancomycin (n = 10; 5 mg/mL), or tobramycin (n = 10; 1 mg/mL) for 10 minutes. Grafts were then removed from the treated gauze swab wraps and mechanically tested under uniaxial tension loading conditions. Grafts were pulled at a rate of 10 mm/min to failure. Force and displacement data from each test were used to calculate the Young modulus (MPa), ultimate tensile stress (MPa), and elasticity limit (MPa). There were no significant differences in Young modulus (552 ± 108, 583 ± 98, and 660 ± 237 MPa; P = .62), ultimate tensile stress (91.5 ± 20.8, 96.6 ± 17.8, and 99.7 ± 33.3 MPa; P = .85), or elasticity limit (51.7 ± 16.4, 53.2 ± 13.8, and 52.3 ± 15.3 MPa; P = .98) between the control, vancomycin, and tobramycin groups, respectively. Soaking of tibialis tendon grafts with tobramycin does not appear to alter mechanical properties of the tendon graft under uniaxial load conditions. If vancomycin use is not possible or contraindicated for certain patients, surgeons can soak grafts in tobramycin to achieve similarly effective infection mitigation without weakening the graft.

Objectives: The objective of this study was to determine whether there is any significant difference between the functional outcome of the knee using a hamstring (HS) graft and peroneus longus (PL) tendon graft after arthroscopic anterior cruciate ligament (ACL) reconstruction. Materials and Methods: A study was done on 140 patients from January 2021 to January 2022 as per inclusion criteria. All patients underwent arthroscopic ACL reconstruction using PL tendon and HS tendon grafts. Patients were followed up with the International Knee Documentation Committee (IKDC) and Modified Cincinnati Score (MCS) for a period of 12 months. Average time of surgery and complications if any were noted. Results: At one year follow-up, the IKDC score was 91.98 ± 3.92 and 91.74 ± 6.93, respectively, for PL and HS groups with P = 0.803. Similarly, the MCS had P = 0.161 and mean values for PL and HS groups being 92.86 ± 3.88 and 91.80 ± 4.67, respectively. Conclusion: The present study shows that the PL tendon autograft has slightly better outcomes on knee functional scores (IKDC and MCSs) to that derived from HS graft in arthroscopic reconstruction of ACL tear over one year of follow-up. PL can be considered as an alternative graft option, but further studies are needed in other sex and age groups and using different functional knee scores to establish the superiority of PL graft over HS graft.

Background: Outcome studies on ACL reconstruction have assessed and compared different surgical techniques. Aim of the study: This study aimed to compare the outcomes of anterior cruciate ligament restoration with semitendinosus-gracilis tendon autograft and peroneus longus tendon autograft at 2 years post-surgery. Methods: This study was conducted in Department of Orthopaedics & Traumatology, TMSS Medical College & Rafatullah Community Hospital (TMC & RCH), Bogura, Bangladesh, Uttara Adhunik Medical College and Hospital, Uttara, Dhaka., Bangladesh & Enam Medical College Hospital, Savar, Dhaka, Bangladesh. A prospective examination was conducted on 50 patients with isolated anterior cruciate ligament damage who had peroneus longus tendon autograft reconstruction. Out of these, 42 patients were followed up. The semitendinosus-gracilis tendon autograft group consisted of 50 consecutive patients who met the same criteria, with 45 accessible for follow-up. All data was gathered, documented in a Microsoft Excel spreadsheet, and analyzed with descriptive statistics in SPSS 16.0. All data was collected, documented in a Microsoft Excel work sheet, and analyzed using descriptive statistics in SPSS 16.0. Results: Ninety percent of patients with peroneus longus tendon had good or excellent results, while 91% had good or excellent results with semitendinosus-gracilis tendon. 86% of patients in the peroneus longus tendon group were assessed as normal or if patients with ruptures or atraumatic failures were assumed to have scored grade D, then there were 82% in the peroneus longus group and 89% in the semitendinosus-gracilis tendon group scoring grade A or B. There was no significant difference between the peroneus longus and semitendinosusgracilis tendon groups in any of the other IKDC subcategories at 2 years. In the hamstring tendon group anterior kneeling pain was present in 6% at both 1 and 2 years (P < 0.0002). Conclusion: In terms of clinical stability, range of motion, and general symptoms, patients undergoing ACL restoration with a semitendinosus-gracilis tendon graft had the same outcome as those receiving a peroneus longus tendon graft. There was no difference in the return to level I or II sports, while more peroneus longus tendon patients reached level I

Background: Allograft tendons are frequently used for ligament reconstruction about the knee, but they entail availability and cost challenges. The identification of other tissues that demonstrate equivalent performance to preferred tendons would improve limitations. Hypothesis/Purpose: We compared the biomechanical properties of 4 soft tissue allograft tendons: tibialis anterior (TA), tibialis posterior (TP), peroneus longus (PL), and semitendinosus (ST). We hypothesized that allograft properties would be similar when standardized by the looped diameter. Study Design: Controlled laboratory study. Methods: This study consisted of 2 arms evaluating large and small looped-diameter grafts: experiment A consisted of TA, TP, and PL tendons (n = 47 each) with larger looped diameters of 9.0 to 9.5 mm, and experiment B consisted of TA, TP, PL, and ST tendons (n = 53 each) with smaller looped diameters of 7.0 to 7.5 mm. Each specimen underwent mechanical testing to measure the modulus of elasticity (E), ultimate tensile force (UTF), maximal elongation at failure, ultimate tensile stress (UTS), and ultimate tensile strain (UTε). Results: Experiment A: No significant differences were noted among tendons for UTF, maximal elongation at failure, and UTϵ. UTS was significantly higher for the PL (54 MPa) compared with the TA (44 MPa) and TP (43 MPa) tendons. E was significantly higher for the PL (501 MPa) compared with the TP (416 MPa) tendons. Equivalence testing showed that the TP and PL tendon properties were equivalent or superior to those of the TA tendons for all outcomes. Experiment B: All groups exhibited a similar E. UTF was again highest in the PL tendons (2294 N) but was significantly different from only the ST tendons (1915 N). UTϵ was significantly higher for the ST (0.22) compared with the TA (0.19) and TP (0.19) tendons. Equivalence testing showed that the TA, TP, and PL tendon properties were equivalent or superior to those of the ST tendons. Conclusion: Compared with TA tendons, TP and PL tendons of a given looped diameter exhibited noninferior initial biomechanical strength and stiffness characteristics. ST tendons were mostly similar to TA tendons but exhibited a significantly higher elongation/UTϵ and smaller cross-sectional area. For smaller looped-diameter grafts, all tissues were noninferior to ST tendons. In contrast to previous findings, PL tendons proved to be equally strong. Clinical Relevance: The results of this study should encourage surgeons to use these soft tissue allografts interchangeably, which is important as the number of ligament reconstructions performed with allografts continues to rise.

Background: Reconstruction of the anterior cruciate ligament (ACL) is a commonly performed surgical procedure in recent years. Surgeons have to consider several factors including patient’s anthropometric variables to harvest the best graft. The hamstring tendon has its’ limitation, such as the tendon graft size deemed unfit especially for people of small statures. The peroneus longus tendon is a relatively new choice compared to hamstring. This study was conducted to know the correlation between anthropometric features with graft parameters or graft size in patients who underwent ACL reconstruction using peroneus longus and hamstring tendons.Materials and Methods: This cross-sectional study was performed in patients who underwent ACL reconstruction using peroneus longus or hamstring tendon autografts. We evaluated their anthropometric variables (age, gender, body mass index (BMI), height and weight) and correlated them with the graft diameter obtained during surgery. Post-operative results were assessed with Karlsson and Peterson Scoring System which represent the ankle function.Results: Twenty-three non-athletic patients underwent ACL reconstruction surgery. Patients with hamstring graft have the average height of 170 cm and 163.6 cm for the peroneal graft group. The average body weight of the hamstring graft group was 72.917 kg and the peroneal graft group was 68.82 kg. The measured BMI of the hamstring graft group was 25.2 kg/m2 and 7.833 mm of graft diameter in average, with 25.5 kg/m2 and 7.636 mm respectively for the peroneus graft group. There were strong positive correlations between weight and BMI with hamstring tendon graft diameter, but negative weak correlations with peroneus tendon graft diameter.Conclusion: We found that body weight and BMI correlate with the diameter of both peroneus and hamstring tendon grafts. Both autografts showed equally good functional results.

A biomechanical comparison of three lower extremity tendons for ligamentous reconstruction about the knee

Anisotropy of bovine cortical bone tissue damage properties

With the increasing use of hamstring tendon as an autograft in anterior cruciate ligament (ACL) reconstruction, some shortcomings have been found on the donor site. Therefore, an alternative autograft option with adequate strength and less donor site morbidity will be very valuable. Peroneus longus tendon has been found to be a promising option. Primary ACL reconstruction. Peroneus longus tendon graft is harvested with a longitudinal skin incision at 2 to 3 cm (2 finger-breadths) above and 1 cm (1 finger-breadth) behind the lateral malleolus, followed by superficial fascia incision in line with skin incision. The peroneus longus and peroneus brevis tendons were then identified. The tendon division location was marked at 2 to 3 cm above the level of the lateral malleolus. After that, an end-to-side suture was performed between the distal part of the peroneus longus tendon and peroneus brevis tendon. The peroneus longus tendon was stripped proximally with a tendon stripper to at least 5 cm from the fibular head to prevent peroneal nerve injury. Graft preparation was performed with a standard procedure to obtain the suitable graft size. In routine arthroscopic ACL reconstruction, peroneus longus tendon graft fixation can be performed with a cortical suspension device, bioabsorbable screws, or a combined technique. Recent studies showed that peroneus longus autograft had a comparable outcome with hamstring tendon autograft in primary ACL reconstruction at a 1-year follow-up. The use of peroneus longus tendon autograft resulted in larger graft diameter and less thigh hypotrophy. The mean (±SD) for the AOFAS-Hindfoot Score in the peroneus longus group was 97.3 ± 4.2, while the mean FADI score was 98 ± 3.4, both of which were considered excellent results. The use of peroneus longus autograft in primary ACL reconstruction is a safe procedure with an excellent outcome. Peroneus longus tendon autograft can be recommended as an alternative graft in single-bundle ACL reconstruction. Further study of the functional outcome and knee stability evaluation is recommended.

Background: The use of autografts originating from either hamstring tendons or peroneus longus tendons is a surgical option in anterior cruciate ligament (ACL) reconstruction. Objectives: This research aimed to compare the tensile strength between the hamstring tendon and the peroneus longus tendon in ACL reconstruction. The hypothesis of this study was: Peroneus longus grafts have tensile strength equal to hamstring grafts based on living donor patients. Methods: This cross-sectional study was a biomechanical study examining means and standard deviations (SD) by comparing the tensile strength of peroneus longus tendons and hamstring tendons when used as autograft donors in ACL reconstruction. Results: In this study, 51 patients with reconstructive ACL were enrolled. The mean diameter of the hamstring tendon was 7.86 with SD ± 0.69, while the mean diameter of peroneus longus tendon was 7.67 with SD ± 0.63. The mean diameter of the peroneus longus graft was not significantly different. The mean displacement on the hamstring tendon was 2.44 with SD ± 0.42, while the peroneus longus tendon was 2.06 with SD ± 0.14. The peroneus longus tendon had significantly more tensile strength compared to the hamstring tendon. Conclusions: Diameter of the peroneus longus graft was not significantly different from the hamstring graft. However, the peroneus longus graft had more tensile strength than the hamstring graft based on living donor patients.

Tensile strength comparison between peroneus longus and hamstring tendons: A biomechanical study

The purpose of this study was to compare two different methods of joining tendons of similar and dissimilar sizes between recipient and donor tendons for flexor tendon grafts. Flexor digitorum profundus (FDP) and peroneus longus (PL) canine tendons were harvested and divided into four groups. The repair technique we compared was a step-cut (SC) suture and a Pulvertaft weave (PW). FDP tendons were significantly larger in diameter than PL tendons (p < 0.05). The volume of the SC repairs using either FDP or PL tendon as a graft was significantly smaller than PW repairs (p < 0.05). The ultimate load to failure and repair stiffness in FDP graft tendons significantly increased compared with the PL graft tendons (p < 0.05). The SC suture can be used as an alternative to the PW, with similar strength and less bulk for repairs using graft tendons of similar diameter. Surgeons should be aware of the effect of graft tendon size and repair method on strength and bulk when performing flexor tendon grafts.

The analysis of underground oil-shale recovery processes requires knowledge of the mechanical properties of oil shale at various temperatures. The tensile strength, compressive strength, and Young's modulus are of special importance. The variation of these properties with temperature is important when assessing the strength of underground columns and confining walls for process cavities. This paper presents the results of an experimental study to quantify this temperature dependence. We found that both tensile and compressive strengths of oil shale show a marked decrease in strength as temperature increased, for a given richness. For example, for 15.6 gal/ton oil shale, the tensile strength at 400 deg. F is only 28% of its room temperature value. For 19.2 gal/ton shale, the compressive strength at 400 deg. F with 500-psi confining pressure is 43% of its value at room temperature. At a given temperature, both the tensile and compressive strengths decrease as richness increases, although the rate of decrease diminishes at richnesses of about 42 gal/ton and higher. Equations are developed to permit estimates of the various parameters involved. The compressive Young's moduli show a considerable decrease with temperature. At 400 deg. F the modulus is reduced to 51% of its room temperature value. Introduction In-situ processes for recovery of oil from nahcolite-bearing oil shale usually involve some heating or pyrolysis of the shale. Wet processes (steam, hot water) also involve dissolution of nahcolite to generate pore space and to create permeability. If the leaching of nahcolite is conducted at a sufficiently high temperature, some stress will develop in the rock beyond the heated cavity boundary because of CO2 generation and possibly water vapor, as follows. 2NaHCO3 goes to Na2CO3 + H2O + CO2. When the decomposition pressure of nahcolite is high enough, the rock tends to fracture ("popcorn effect"). Rubbling of the formation then can occur. To predict conditions suitable for fracturing and rubbling, we need to know how the rock tensile strength varies with temperature. McLamore measured the oil-shale tensile strength as a function of orientation of stress. So far as we know, no measurements of tensile strength as a function of temperature have been reported for oil shale. We also need to know the variation of nahcolite decomposition pressure with temperature. This pressure variation was measured by Templeton. The variation of Young's modulus, compressive strength, and Poisson's ratio also have been reported for various richnesses. Logan and Heard studied the compressive Young's modulus and thermal expansion as functions of richness. Compressive strength of oil shale has been studied extensively. This parameter was measured as a function of oil-shale richness for various confining pressures in triaxial tests at temperatures up to 300 deg. C (572 deg. F). The effect of temperature on rocks other than oil shale has also been studied. Knowledge of the compressive strength is important when assessing the possibility of failure of underground supporting walls in mines or with process cavities. Since the reacted oil shale probably will support the walls or the roofs of the process cavities very little, the strength of the supporting walls and roof under process conditions will determine the tendency for subsidence or intercavity communication. SPEJ P. 301^

The purpose of our work – is to show our version of determining the strength properties, elastic modules and compressibility factors at reservoir conditions on the example of rock fields OOO "LUKOIL–Western Siberia". This paper briefly shows a method of measurement and processing of the results. The paper also shows some results of the determination of dynamic and static elastic moduli of rocks (Poisson's ratio, Young's modulus, shear modulus, compressibility, ultimate strength, elastic limits). This article also shows some results of a comparison of dynamic and elastic Young's modulus. Static deformation and strength characteristics of the rock were determined by direct measurements of the longitudinal and transverse strains. All measurements were made at reservoir conditions by increasing the axial load until destruction of the sample. The rate of deformation changes was no more than 1.5 • 10-6 s-1, reservoir pressure and temperature were maintained automatically with a high degree of accuracy. Static deformation and strength characteristics are the most reliable, and reflect real properties of both homogeneous and heterogeneous anisotropic rocks. In our laboratory, on by our optimized measurement method were performed investigations of dynamic and static strength properties of more than 500 rock samples from different oilfields of OOO "LUKOIL–Western Siberia". Our Company has received a very valuable information about the rocks in the form of diagrams "Stress–Strain," of Mohr's circles, elastic limits, ultimate strengths, elastic modulus, graphs of compressibility factor and Biot's coefficients depending on the pressures. It should also be noted that we have not been able to find any general and uniform dependence (laws) in all studied formations and fields, between dynamic and static elastic moduli. For solving of some specific tasks (for example, a field development, design of hydraulic fracturing) and for obtaining high–quality and reliable results on the rock mechanics we need use only static strength characteristics of rocks identified at true reservoir conditions. Our methodology is based on the American Standard ASTM D 3148–93, and the results of our experimental work and the measurement procedure (Owner's Manual) for our equipment, taking into account the specific properties of sedimentary rocks of OOO "LUKOIL–Western Siberia". For concrete oil formations studied fields of OOO "LUKOIL–Western Siberia" we had found quite close links between the dynamic and static Young's modulus. Such petrophysical links is possible to use for obtaining more important information from the results of rocks research by dynamic method.

Anterior cruciate ligament (ACL) reconstruction is a commonly performed orthopedic procedure, with autologous grafts, such as hamstring and peroneus longus tendons, widely used. Emerging evidence suggests that the peroneus longus tendon may offer comparable or superior functional outcomes with minimal donor-site morbidity, yet limited comparative data are available in the Pakistani population. Objective: To compare the functional outcomes of ACL reconstruction using hamstring tendon grafts versus peroneus longus tendon grafts, assessed by the International Knee Documentation Committee (IKDC) score at three months postoperatively. Methods: A randomized controlled trial was conducted in the Department of Orthopaedic Surgery at Nishtar Hospital, Multan, from 15 February to 15 May 2025, enrolling 78 patients aged 20–50 years with isolated ACL injuries. Participants were randomized into two equal groups: Group A underwent ACL reconstruction using a hamstring tendon autograft, while Group B received an autograft from the peroneus longus tendon. Standardized postoperative rehabilitation was followed. Functional outcomes were assessed using the IKDC score at three months. Data were analyzed using SPSS version 22, with independent t-tests and stratified analyses to control for effect modifiers. A p-value &lt; 0.05 was considered statistically significant. Results: The mean IKDC score was significantly higher in the peroneus longus group (83.1 ± 5.8) compared with the hamstring group (78.6 ± 6.9) (p &lt; 0.01). Stratified analyses demonstrated consistently higher IKDC scores across age groups, gender, residence, and socioeconomic strata, with no subgroup favoring the hamstring graft. Baseline demographic and clinical characteristics were comparable between the groups. Conclusion: Peroneus longus autograft demonstrated superior early postoperative functional outcomes compared with the hamstring autograft. These findings support the use of the peroneus longus tendon as a reliable and effective alternative for ACL reconstruction in the Pakistani population.