title: A biomechanical comparison of fan-folded, single-looped fascia lata with other graft tissues as a suitable substitute for anterior cruciate ligament reconstruction.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the initial biomechanical properties of a fan-folded, single-loop construct of fan-folded fascia lata allograft in comparison to other graft tissues currently being used for anterior cruciate ligament (ACL) reconstruction.
  
  
  METHODS
  Eighteen fascia lata specimens were harvested from 11 donors and fan folded through a proprietary process. Bone-patellar tendon-bone (BPTB), tibialis anterior, tibialis posterior, and peroneus longus tendons were harvested from 4 additional donors. All soft-tissue grafts were tested to failure in an MTS machine (MTS Systems, Eden Prairie, MN) in a single-looped fashion. BPTB grafts were similarly clamped in freeze grips. The ultimate load to failure and stiffness were calculated for each graft type tested.
  
  
  RESULTS
  The mean ultimate load to failure was 3,266 N and stiffness was 414 N/mm for the single-looped fascia lata grafts (n = 18). There was no significant difference for ultimate load to failure and stiffness between the fascia lata and tibialis anterior (3,012 N and 342 N/mm, respectively), tibialis posterior (3,666 N and 392 N/mm, respectively), and peroneus longus (3,050 N and 346 N/mm, respectively) tendons. The fascia lata grafts performed significantly better (P < .001) than BPTB (1,404 N and 224 N/mm, respectively).
  
  
  CONCLUSIONS
  A single-loop construct of fan-folded fascia lata allograft has, on biomechanical testing, initial ultimate tensile strength (3,266 N) and stiffness values equivalent to or better than several other graft tissues currently used in ACL reconstruction, including BPTB (1,403 N), tibialis anterior (3,012 N), tibialis posterior (3,666 N), and peroneus longus (3,050 N).
  
  
  CONCLUSIONS
  In the face of potential allograft tissue shortages and increasing constraints on health care expenditures, the use of fascia lata has the potential to be a readily available graft for ACL reconstruction that performs as well as other grafts and at a comparable or lower cost.
authors.affiliation: Department of Orthopaedic Surgery, University of Miami Miller School of Medicine, Florida 33136, USA. daniel2379@hotmail.com
authors.forename: Daniel B
authors.initials: DB
authors.lastname: Chan
authors.forename: H Thomas
authors.initials: HT
authors.lastname: Temple
authors.forename: Loren L
authors.initials: LL
authors.lastname: Latta
authors.forename: Siddharth
authors.initials: S
authors.lastname: Mahure
authors.forename: Jeremy
authors.initials: J
authors.lastname: Dennis
authors.forename: Lee D
authors.initials: LD
authors.lastname: Kaplan
mesh_terms: D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D001182:Arthroscopy / Q000379:methods*; D001696:Biomechanical Phenomena; D016025:Bone Transplantation; D005206:Fascia Lata / Q000637:transplantation*; D005260:Female; D006801:Humans; D008297:Male; D008422:Materials Testing; D008875:Middle Aged; D009928:Organ Specificity; D017847:Patellar Ligament / Q000637:transplantation; D013710:Tendons / Q000637:transplantation; D013718:Tensile Strength; D016474:Weight-Bearing; D055815:Young Adult