Biomechanical analysis of patellar tendon allografts as a function of donor age.

We evaluated the biomechanical properties of patellar tendon allografts from donors aged 18 to 55 years. Bone-patellar tendon-bone complexes were harvested from acceptable donors and processed. Fat and soft tissue were removed, and the tendons were sectioned lengthwise leaving the central third. Area measurements were taken, and mechanical testing was performed. Specimens were pulled to failure at a rate of 10% of the initial length per second. The force at failure, tensile stress, modulus of elasticity, and percent elongation were determined for each specimen. There was no significant correlation (P > 0.05) between age and any of the mechanical properties. Load at failure ranged from 2110 to 4650 N, with a mean of 3424 N. Regression analysis showed slightly decreasing tensile stress with increasing age, but the correlation was not significant. It appears that patellar tendon allografts from donors up to age 55 have similar mechanical properties.

Works in progress #7. Age-dependent fibrin clot invasion by human meniscal fibrochondrocytes. A preliminary report.

This study was performed to determine whether human fibrochondrocytes possess the same biologic potential for initiating a reparative response in a meniscal defect as that found in lower vertebrates. Small, circular defects were created in meniscal fragments obtained from nine men aged 14 to 72 years. The defects were filled with purified fibrin and placed in a culture medium. By 4 weeks, there was excellent cellular penetration into all clots. This study suggests that human meniscal fibrochondrocytes are also capable of initiating a reparative response, and the rapidity of this response appears to be age dependent. The 14- and 16-year-old menisci mounted a more rapid healing response in vitro than did those obtained from skeletally mature individuals.

Acute anterior thigh compartment syndrome complicating quadriceps hematoma. Two case reports and review of the literature.

Acute compartment syndrome of the thigh has been reported infrequently. To date, only eight cases from isolated blunt trauma without fracture have been reported. Two additional cases caused by intramuscular hematomas following blunt, low-energy trauma, which were treated successfully with emergency fasciotomies, are presented. The morbidity from this syndrome varies from mild, with quadriceps weakness, fatigue, and myositis ossificans, to severe, with limb-threatening vascular compromise. Morbidity can be avoided if a high level of suspicion is maintained, compartment pressures are measured, fasciotomies are performed, and hematomas are drained. Postoperatively, patients can expect a dramatic decrease in pain and a quick return of quadriceps function with aggressive physical rehabilitation.

Improvements in rehabilitation of the postmeniscectomized or meniscal-repaired patient.

Recent advances in the surgical management of meniscal problems (arthroscopic meniscectomy or meniscal repair) have been associated with far less morbidity postoperatively. Aggressive rehabilitation programs using innovative devices have allowed the patients an early return to normal activities or competition. Even with the best surgical technique, rehabilitation of the hamstring and quadriceps musculature is necessary to provide the patient with an optimal surgical result.