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Characterisation of the tensile properties of Demineralised Cortical Bone when used as an anterior cruciate ligament allograft

Hexter, A; Shahbazi, S; Thangarajah, T; Kalaskar, D; Haddad, F; Blunn, G; (2020) Characterisation of the tensile properties of Demineralised Cortical Bone when used as an anterior cruciate ligament allograft. Journal of the Mechanical Behavior of Biomedical Materials , 110 , Article 103981. 10.1016/j.jmbbm.2020.103981. Green open access

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Abstract

Background: Graft choice in anterior cruciate ligament (ACL) reconstruction remains controversial and some grafts fail due to inadequate osteointegration. Demineralised cortical bone (DCB) is an osteoinductive collagen-based scaffold. The aim of this study was to measure the tensile properties of DCB from different locations and from different ages, and determine its compatibility with current ACL fixation systems. Methods: The tensile properties of DCB manufactured from femur and tibia of young (9 month) and old (2–3 years) sheep was measured to determine the most appropriate graft choice. The ultimate load and stiffness of DCB allograft using two fixation systems, interference screws and sutures tied around screw posts, was measured ex vivo in an ovine ACL reconstruction model. Comparison was made with superficial digital flexor tendon (SDFT) and ovine ACL. Results: DCB derived from young tibia had the highest ultimate load and stiffness of 67.7 ± 10.6 N and 130.2 ± 64.3 N/mm respectively. No DCB fixation system reached the published peak in vivo force through the ovine ACL of 150 N. SDFT fixation with interference screws (308.2 ± 87.3 N) did reach the in vivo threshold but was significantly weaker than ovine ACL (871.0 ± 64.2 N). Conclusion: The tensile properties of DCB were influenced by the donor age and bone. Owing to inferior tensile properties and incompatibility with suspensory fixation devices, this study indicates DCB is inferior to current tendon grafts options for ACL reconstruction.

Type: Article
Title: Characterisation of the tensile properties of Demineralised Cortical Bone when used as an anterior cruciate ligament allograft
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.jmbbm.2020.103981
Publisher version: https://doi.org/10.1016/j.jmbbm.2020.103981
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Anterior cruciate ligament (ACL), Demineralised bone matrix, Demineralised cortical bone, Graft fixation, Tensile properties
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci > Department of Ortho and MSK Science
URI: https://discovery.ucl.ac.uk/id/eprint/10105847
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