title: Tension level during preconditioning influences hamstring tendon graft properties.
abstract: BACKGROUND
  Hamstring tendon grafts used for anterior cruciate ligament reconstruction are preconditioned to reduce the influence of viscoelasticity on the stiffness and tension.
  
  
  OBJECTIVE
  Increasing the tension applied during preconditioning will decrease the loss of tension and stiffness due to viscoelasticity.
  
  
  METHODS
  Controlled laboratory study.
  
  
  METHODS
  Six quadruple-strand hamstring tendon grafts were tested twice in vitro with 2 tension levels applied during preconditioning. The grafts were preconditioned at 80 N or 160 N, followed by 15 minutes of relaxation, and subsequently loaded to 80 N to represent application of initial tension. After 5 minutes of relaxation, the tension was recorded and the stiffness was measured over 0.06 mm of displacement. The tension and stiffness measurements were repeated 3 hours later. The data were compared between the 2 preconditioning levels with a 2-way repeated-measures analysis of variance.
  
  
  RESULTS
  Graft tension and stiffness were significantly larger (P < .05) for 160 N during preconditioning. For 80 N, the average tension at 5 minutes and 3 hours was 40 N and 21 N, respectively, compared with 50 N and 30 N, respectively, for 160 N. For 80 N, the average stiffness at 5 minutes and 3 hours was 152 N/mm and 124 N/mm, respectively, compared with 173 N/mm and 146 N/mm, respectively, for 160 N.
  
  
  CONCLUSIONS
  Increasing the tension applied to hamstring tendon grafts during preconditioning can decrease the postoperative loss of tension and stiffness due to viscoelasticity.
  
  
  CONCLUSIONS
  The increased graft tension and stiffness could reduce postoperative knee laxity.
authors.affiliation: Medical Education and Research Institute of Colorado, Colorado Springs, Colorado, USA. jelias@agmc.org
authors.forename: John J
authors.initials: JJ
authors.lastname: Elias
authors.forename: Srianjana
authors.initials: S
authors.lastname: Kilambi
authors.forename: William J
authors.initials: WJ
authors.lastname: Ciccone
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D001696:Biomechanical Phenomena; D002102:Cadaver; D004548:Elasticity; D006801:Humans; D007593:Joint Instability / Q000517:prevention & control; D007719:Knee Joint; D013710:Tendons / Q000637:transplantation*; D013718:Tensile Strength; D019737:Transplants; D016474:Weight-Bearing