New research has challenged the understanding of tendon suitability for knee reconstruction
With an increasing number of people suffering anterior cruciate ligament (ACL) injuries, researchers at the Kolling Institute said a broader range of tendon grafts could be successfully adopted by surgeons undertaking knee reconstructions.
“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 now 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. “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.” Lab 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 experience this increasingly common ACL injury.
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 tendons 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.
The research, which was the second-largest human tendon study ever published, prompted calls for tissue banks to review current age restrictions and the range of tendons approved for grafts. The study comes as Australia continues to record one of the highest rates of ACL injuries in the world. Interestingly, these injuries are not limited to professional athletes but are impacting all age groups, particularly children in the five to 14 age range. Study lead PhD student Dylan Ashton said if you were to
Dylan Ashton and Associate Professor Elizabeth Clarke
36 NSLHD 2023 Year in Review
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