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Quadruple semitendinosus and gracilis tendons
72%
2261/3141
Bone-patellar tendon-bone with a width of 10 mm
16%
498/3141
Bone-quadriceps tendon with a width on 10mm
4%
118/3141
Tibialis tendon allograft
1%
38/3141
Native anterior cruciate ligament (ACL)
6%
204/3141
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Biomechanical studies show that the quadruple semitendinosus and gracilis tendons are the strongest of the tissues on maximal load to failure testing. All of the potential ACL grafts mentioned are stronger than native ACL. Wilson et al looked at cadaveric specimens (mean age 40) and found average load to failure for the patellar tendon grafts was 1784 +/- 580 N compared with 2422 +/- 538 N for the quadrupled hamstring tendon grafts, which was significantly different. Woo et al tested native ACL ultimate load in cadavers and reported a mean of 2160 +/- 157 N in young patients tested in the anatomical orientation, which was higher than previous reports. Staubli et al compared preconditioned quad to patellar tendon grafts and found ultimate failure at 2353 +/- 495 N for QT-B complexes and 2376 +/- 152 N for B-PL complexes. However, all of these grafts are reasonable and other structural properties such as graft size, stiffness, creep, and strength of fixation are also important considerations.
4.3
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