Soaking versus moist storage of autologous patellar tendon before implantation for ACL reconstruction: A cadaver study

After a bone-patellar tendon-bone graft has been harvested and prepared, the graft must be stored while other surgical tasks are completed. We compared the tendon weight and pull-through force of 2 graft storage methods using 8 cadaveric patellar tendon pairs. One specimen in each pair was soaked in normal saline and the other stored in moist gauze. Weight at 0 vs 5, 0 vs 20, and 5 vs 20 minutes of soaking or storage in moist gauze was significantly higher in the soaked group (P<.01). Pull-through force in both groups increased significantly with time, with force in the soaked group increasing by 20%. The percent pull-through force change for the grafts stored in moist gauze was not significantly different in the first 5 minutes compared to the following 15 minutes. Swelling of the graft could have adverse clinical effects if passage through the bone tunnels is made difficult or if the tendon is damaged during its passage through the tunnels. Increased pull-through force may increase the potential for difficulty passing the graft and for damaging the graft. Increased pull-through force can also slow the overall procedure. This study suggests grafts stored in moist gauze may swell less and have a lower pull-through force throughout the intraoperative storage period compared to saline-soaked grafts. These findings suggest grafts should be stored in moist gauze as opposed to soaked and implanted as quickly as possible to limit potential problems with graft passage during anterior cruciate ligament reconstruction.