Mechanical Tensile Properties of the Quadriceps Tendon and Patellar Ligament in Young Adults

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Abstract

We analyzed mechanical tensile properties of 16 10-mm wide, full-thickness central parts of quadriceps tendons and patellar ligaments from paired knees of eight male donors (mean age, 24.9 years). Uniaxial tensile testing was performed in a servohydraulic materials testing machine at an extension rate of 1 mm/sec. Sixteen specimens were tested unconditioned and 16 specimens were tested after cyclic preconditioning (200 cycles between 50 N and 800 N at 0.5 Hz). Mean cross-sectional areas measured 64.6 +/- 8.4 mm2 for seven unconditioned and 61.9 +/- 9.0 mm2 for eight preconditioned quadriceps tendons and were significantly larger than those values of seven unconditioned and seven preconditioned patellar ligaments (36.8 +/- 5.7 mm2 and 34.5 +/- 4.4 mm2, respectively). Mean ultimate tensile stress values of unconditioned patellar ligaments were significantly larger than those values of unconditioned quadriceps tendons: 53.4 +/- 7.2 N/mm2 and 33.6 +/- 8.1 N/mm2, respectively. Strain at failure was 14.4% +/- 3.3% for preconditioned patellar ligaments and 11.2% +/- 2.2% for preconditioned quadriceps tendons (P = 0.0428). Preconditioned patellar ligaments exhibited significantly higher elastic modulus than preconditioned quadriceps tendons. Based on mechanical tensile properties analyses, the quadriceps tendon-bone construct may represent a versatile alternative graft in primary and revision anterior and posterior cruciate ligament reconstruction.

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Tensile properties of the human femur-anterior cruciate ligament-tibia complex

Roger Lyon, Savio Woo, Douglas J Adams … (2016)

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Anterior cruciate ligament reconstruction using one-third of the patellar ligament, augmented by extra-articular tendon transfers.

R Narechania, Heidi D. Nelson, Kathleen Clancy … (1982)

Eighty patients with persistent clinical and functional instability of the knee due to anterior cruciate ligament insufficiency underwent the operation reported, in which one-third of the patellar ligament substitutes for the cruciate ligament and extraarticular tendon transfers, medial and lateral, augment the substitution. The patients were followed for a minimum of two years, and fifty returned for personal evaluation. The average follow-up was thirty-three months, with a range of two to five years. There were thirty-five male and fifteen female patients. The average age was twenty-three years. The average interval from initial injury to the index operation was two years. Meniscal tears and articular changes were noted in most of the patients. Forty-three (86 per cent) of the fifty patients had at least one torn meniscus, twenty-seven patients (54 per cent) had significant degenerative articular changes, and fourteen (28 per cent) had patellar articular changes. In the procedure described, eccentric placement of the tibial and femoral tunnels for more accurate placement of the patellar ligament substitute is essential. The over-all results were graded as excellent in thirty knees, good in seventeen, fair in one, and a failure in two. One knee that was classified as a failure showed excellent stability, but the patient had significant pain from chondromalacia of the patella, while significant pain and hyperesthesia from a neuroma was the reason for failure in the second patient.