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New research testing tendon suitability for knee surgery

With an increasing number of people suffering anterior cruciate ligament (ACL) injuries, researchers at the Kolling Institute say 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 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 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 reruptured 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.
Study lead PhD student Dylan Ashton

“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

“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 donor age was not associated with weaker tendons even when including donors into their 90s - 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 are important as it means 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.

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