Effect of electron beam irradiation on biomechanical properties of patellar tendon allografts in anterior cruciate ligament reconstruction.
BACKGROUND
Sterilization of anterior cruciate ligament (ACL) allografts is an important prerequisite to prevent disease transmission. However, mechanical tissue properties are compromised by most current sterilization procedures, so that uncompromised sterilization of allografts is difficult to achieve. Hypothesis/


OBJECTIVE
The aim of this study was to evaluate the effect of the novel electron beam sterilization procedure on the biomechanical properties of human patellar tendon allografts at various irradiation dosages. Electron beam sterilization may be an appropriate alternative to gamma sterilization.


METHODS
Controlled laboratory study.


METHODS
Thirty-two human 10-mm wide bone-patellar tendon-bone grafts were randomized into 4 groups of sterilization with 15, 25, or 34 kGy of electron beam irradiation, respectively. The grafts' biomechanical properties were evaluated at time zero. Unsterilized grafts functioned as controls. Biomechanical properties were analyzed during cyclic and load-to-failure testing.


RESULTS
Strain and cyclic elongation response showed no significant differences between the groups. Electron beam irradiation had no significant effect on stiffness and failure load with the exception of 34 kGy, which resulted in a significant decrease in failure load (1300.6 +/- 229.2 N) compared with unsterilized grafts (1630.5 +/- 331.1 N).


CONCLUSIONS
This study showed that electron beam might be an appropriate alternative in sterilization of patellar tendon allografts with minimal effect on mechanical properties of tendon grafts in vitro. Future studies will have to evaluate the effect of the process on the biological properties of allografts in vitro and in vivo.


CONCLUSIONS
Terminal sterilization of patellar tendon allografts with electron beam irradiation can ensure higher safety of transplanted grafts and hence improve patient safety and acceptance.
Hoburg
Arnd T
AT
Sports Medicine & Arthroscopy Service, Hospital for Orthopaedic Surgery and Traumatology, Campus Mitte, Charité, University Medicine Berlin, Chariteplatz 1, Berlin, Germany. arnd.hoburg@charite.de
Keshlaf
Salahedeen
S
Schmidt
Tanja
T
Smith
Mark
M
Gohs
Uwe
U
Perka
Carsten
C
Pruss
Axel
A
Scheffler
Sven
S
D000328:Adult; D000368:Aged; D016118:Anterior Cruciate Ligament / Q000382:microbiology*; D001669:Biochemical Phenomena / Q000528:radiation effects*; D018562:Disease Transmission, Infectious / Q000517:prevention & control; D005720:Gamma Rays; D006801:Humans; D008875:Middle Aged; D017847:Patellar Ligament / Q000637:transplantation*; D011897:Random Allocation; D013242:Sterilization / Q000379:methods*; D013708:Tendon Injuries / Q000601:surgery; D014184:Transplantation, Homologous; D055815:Young Adult