MUSCULOSKELETAL PRIORITY RESEARCH AREA – A SNAPSHOT OF ACTIVITY
New research challenges our understanding of tendon suitability for knee reconstructions
With an increasing number of people suffering anterior cruciate ligament (ACL) injuries, researchers at the Kolling Institute published new research suggesting a broader range of tendon grafts could be successfully adopted by surgeons undertaking knee reconstructions. The research, which is the second-largest human tendon study ever published** is prompting calls for tissue banks to review current age restrictions and the range of tendons approved for grafts. The findings came as Australia continued to record one of the highest rates of ACL injuries in the world. Interestingly, these injuries are not limited to professional athletes, but impact all age groups, particularly children in the five to 14 years age range. Study lead PhD student Dylan Ashton said if you were to rupture your ACL today and opt for surgical treatment, your orthopaedic surgeon would most likely use your hamstring tendons as a graft to reconstruct your ACL. “This approach however, can cause additional pain and create functional deficits. It can also be difficult to source enough healthy tendon in younger patients, and those who have re-ruptured their ACL,” he said. “These issues have increased the popularity of using tendon allografts, which are sourced from deceased human tissue donors. “Currently there are strict limitations around the type of allografts used, and age limits where tissue banks will only accept donors up to the age of 65 years. “We expect our research findings will prompt a review of these restrictions. “We mechanically assessed the strength of nine tendons from the lower leg, three commonly used as allografts, and six new candidates.
Dylan Ashton and Associate Professor Elizabeth Clarke
“As part of our research, we investigated the impact of donor age, sex, height and weight on the biomechanical properties of the graft. “Importantly, we found that donor age was not associated with weaker tendons, even when including donors into their nineties - and the strength of the new tendons was higher than the strength of tendons which are commonly used as allografts.” Murray Maxwell Biomechanics Laboratory Director, Associate Professor Elizabeth Clarke, said the findings were important as it meant there could be a much broader range of tendon options available to surgeons and their patients, and this could directly improve outcomes for those who experienced increasingly common ACL injuries. ** Ashton DM, Blaker CL, Hartnell N, Haubruck P, Hefferan SA, Little CB, Clarke EC. Challenging the Perceptions of Human Tendon Allografts: Influence of Donor Age, Sex, Height, and Tendon on Biomechanical Properties. Am J Sports Med. 2023 Mar;51(3):768-778. doi: 10.1177/03635465221143385
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