Allograft Ligament Reconstruction: Biomechanical Issues and Testing

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SummaryThe biomechanical factors that influence the ultimate outcome of ligament reconstruction are described and discussed in the context of experimental studies on allograft reconstruction. Proper choice of animal model and experimental design is emphasized. Selection of appropriate allograft tissue is discussed in terms of the structural properties of the reconstructed bone-soft tissue-bone complex, and the material properties of the soft-tissue substance. The effects of processing and sterilization on graft biomechanical properties are outlined. The requirements for proper initial fixation are presented, and the relative merits of the different methods are discussed. The in vivo changes in allograft properties are shown to be similar to those found for autograft tissues. In general, studies have found that an anterior cruciate ligament allograft with stiffness and ultimate load approaching 30–35% of control values at 1 year postoperatively is typical. Methods used to examine joint kinematics are described, and the results of kinematic analysis of healed allograft reconstructions are summarized. Restoration of normal knee kinematics is emphasized to be the ultimate goal of any ligament reconstruction procedure.

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