Effect of ACL Reconstruction Graft Material on Joint Force Loss During Cyclic Fatigue Testing Using a 6-DOF Motion

2010 ◽  
Author(s):  
Daniel V. Boguszewski ◽  
Jason T. Shearn ◽  
Christopher T. Wagner ◽  
David L. Butler
Keyword(s):  
Fatigue Testing ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Cyclic Fatigue ◽  
Anterior Tibial Translation ◽  
Graft Material ◽  
Joint Force ◽  
Anterior Tibial ◽  
Anterior Cruciate ◽  
Tibial Translation

As many as 250,000 people suffer anterior cruciate ligament (ACL) injury annually [1]. As the primary ligamentous restraint to anterior tibial translation [2–3], the ACL is surgically reconstructed in an attempt to restore knee stability. However, up to 10–25% of reconstructions still fail [4]. While reconstructions restore antero-posterior kinematics, abnormal kinematics persist in other directions [5], leading to a shift in cartilage contact and poor adaptation to altered load [5]. With or without reconstruction, the likely prognosis after ACL injury is long-term osteoarthritis [6]. Improving this outcome requires assessment of the limitations of ACL graft reconstruction compared to normal ACL forces during simulated activities of daily living (ADLs). Our objective in this study was to evaluate the magnitude and temporal changes in force for the intact versus ACL-reconstructed knee over 2000 cycles of a simulated ADL.

scholarly journals Excessive anterior tibial translation in the contralateral uninjured limb is significantly associated with ramp lesion in anterior cruciate ligament injury

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Kazuki Asai ◽  
Junsuke Nakase ◽  
Rikuto Yoshimizu ◽  
Mitsuhiro Kimura ◽  
Hiroyuki Tsuchiya
Keyword(s):  
Risk Factors ◽  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Anterior Tibial Translation ◽  
Ramp Lesion ◽  
Anterior Tibial ◽  
Male Sex ◽  
Anterior Cruciate ◽  
Tibial Translation

Abstract Purpose This study aimed to evaluate the excessive anterior tibial translation (ATT) and muscle strength of patients with ramp lesions. We hypothesised that the higher ATT, lower hamstring-to-quadriceps (HQ) ratio, and higher flexion peak torque influenced by semimembranosus would be associated with ramp lesions. Methods One hundred and twenty-one patients who underwent anterior cruciate ligament (ACL) reconstruction were retrospectively evaluated. Clinical evaluation included ATT of the contralateral uninjured limb measured using a KT-1000 arthrometer, the knee flexor and extensor muscle strength of the contralateral uninjured limb at 60°/s and 180°/s of an angular velocity measured using an isokinetic dynamometer, and HQ ratio at 60°/s and 180°/s during the preoperative state. Binary stepwise logistic regression analysis was performed to evaluate the risk factors of ramp lesions. Results Ramp lesions were found in 27 cases of ACL injuries (27/121, 22.3%). Male sex (odds ratio [OR], 2.913; 95% confidence interval [CI], 1.090–7.787; P = 0.033), longer time between injury to surgery (OR, 2.225; 95% CI, 1.074–4.608; P = 0.031), and higher ATT in the contralateral uninjured limb (OR, 1.502; 95% CI, 1.046–2.159; P = 0.028) were indicated as the independent risk factors of the presence of ramp lesion associated with an ACL injury. Conclusions Male sex, longer period from injury to surgery, and higher ATT in the contralateral uninjured limb were significantly associated with ramp lesion. These findings are advantageous for identifying patients with a greater risk of developing a ramp lesion with an ACL injury in the clinical setting. Level of evidence Level IV

Is Remnant Preservation Truly Beneficial to Anterior Cruciate Ligament Reconstruction Healing? Clinical and Magnetic Resonance Imaging Evaluations of Remnant-Preserved Reconstruction

2017 ◽  
Vol 45 (5) ◽  
pp. 1049-1058 ◽  
Author(s):  
Takuya Naraoka ◽  
Yuka Kimura ◽  
Eiichi Tsuda ◽  
Yuji Yamamoto ◽  
Yasuyuki Ishibashi
Keyword(s):  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Anterior Tibial Translation ◽  
Resonance Imaging ◽  
Graft Incorporation ◽  
Remnant Preservation ◽  
Anterior Tibial ◽  
Anterior Cruciate ◽  
Tibial Translation

Background: Remnant-preserved anterior cruciate ligament (ACL) reconstruction was introduced to improve clinical outcomes and biological healing. However, the effects of remnant preservation and the influence of the delay from injury until reconstruction on the outcomes of this technique are still uncertain. Purpose/Hypothesis: The purposes of this study were to evaluate whether remnant preservation improved the clinical outcomes and graft incorporation of ACL reconstruction and to examine the influence of the delay between ACL injury and reconstruction on the usefulness of remnant preservation. We hypothesized that remnant preservation improves clinical results and accelerates graft incorporation and that its effect is dependent on the delay between ACL injury and reconstruction. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 151 consecutive patients who underwent double-bundle ACL reconstruction using a semitendinosus graft were enrolled in this study: 74 knees underwent ACL reconstruction without a remnant (or the remnant was <25% of the intra-articular portion of the graft; NR group), while 77 knees underwent ACL reconstruction with remnant preservation (RP group). These were divided into 4 subgroups based on the time from injury to surgery: phase 1 was <3 weeks (n = 24), phase 2 was 3 to less than 8 weeks (n = 70), phase 3 was 8 to 20 weeks (n = 32), and phase 4 was >20 weeks (n = 25). Clinical measurements, including KT-1000 arthrometer side-to-side anterior tibial translation measurements, were assessed at 3, 6, 12, and 24 months after reconstruction. Magnetic resonance imaging evaluations of graft maturation and graft-tunnel integration of the anteromedial and posterolateral bundles were assessed at 3, 6, and 12 months after reconstruction. Results: There was no difference in side-to-side anterior tibial translation between the NR and RP groups. There was also no difference in graft maturation between the 2 groups. Furthermore, the time from ACL injury until reconstruction did not affect graft maturation, except in the case of very long delays before reconstruction (phase 4). Graft-tunnel integration was significantly increased in both groups in a time-dependent manner. However, there was no difference between the NR and RP groups. Conclusion: Remnant preservation did not improve knee stability at 2 years after ACL reconstruction. Furthermore, remnant preservation did not accelerate graft incorporation, especially during the acute and subacute injury phases.

scholarly journals Copers and Noncopers Use Different Landing Techniques to Limit Anterior Tibial Translation After Anterior Cruciate Ligament Reconstruction

2021 ◽  
Vol 9 (4) ◽  
pp. 232596712199806
Author(s):  
Michèle N.J. Keizer ◽  
Egbert Otten ◽  
Chantal M.I. Beijersbergen ◽  
Reinoud W. Brouwer ◽  
Juha M. Hijmans
Keyword(s):  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Anterior Tibial Translation ◽  
Return To Sports ◽  
Beighton Score ◽  
Positive Correlation ◽  
Anterior Tibial ◽  
Flexion Moment ◽  
Anterior Cruciate ◽  
Tibial Translation

Background: At 1 year after anterior cruciate ligament reconstruction (ACLR), two-thirds of patients manage to return to sports (copers), whereas one-third of patients do not return to sports (noncopers). Copers and noncopers have different muscle activation patterns, and noncopers may not be able to control dynamic anterior tibial translation (ATTd) as well as copers. Purpose/Hypothesis: To investigate whether (1) there is a positive correlation between passive ATT (ATTp; ie, general joint laxity) and ATTd during jump landing, (2) whether ATTd is moderated by muscle activating patterns, and (3) whether there is a difference in moderating ATTd between copers and noncopers. We hypothesized that patients who have undergone ACLR compensate for ATTd by developing muscle strategies that are more effective in copers compared with noncopers. Study Design: Controlled laboratory study. Methods: A total of 40 patients who underwent unilateral ACLR performed 10 single-leg hops for distance with both legs. Lower body kinematic and kinetic data were measured using a motion-capture system, and ATTd was determined with an embedded method. Muscle activity was measured using electromyographic signals. Bilateral ATTp was measured using a KT-1000 arthrometer. In addition, the Beighton score was obtained. Results: There was no significant correlation between ATTp and ATTd in copers; however, there was a positive correlation between ATTp and ATTd in the operated knee of noncopers. There was a positive correlation between the Beighton score and ATTp as well as between the Beighton score and ATTd in both copers and noncopers in the operated knee. Copers showed a negative correlation between ATTd and gastrocnemius activity in their operated leg during landing. Noncopers showed a positive correlation between ATTd and knee flexion moment in their operated knee during landing. Conclusion: Copers used increased gastrocnemius activity to reduce ATTd, whereas noncopers moderated ATTd by generating a smaller knee flexion moment. Clinical Relevance: This study showed that copers used different landing techniques than noncopers. Patients who returned to sports after ACLR had sufficient plantar flexor activation to limit ATTd.

scholarly journals Computer-Assisted System in Stress Radiography for Anterior Cruciate Ligament Injury with Correspondent Evaluation of Relevant Diagnostic Factors

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 419
Author(s):  
Chien-Kuo Wang ◽  
Liang-Ching Lin ◽  
Yung-Nien Sun ◽  
Cheng-Shih Lai ◽  
Chia-Hui Chen ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Cruciate Ligament ◽  
Anterior Tibial Translation ◽  
Computer Assisted ◽  
Time Interval ◽  
Stress Radiography ◽  
Factors Affecting ◽  
Anterior Tibial ◽  
Anterior Cruciate ◽  
Tibial Translation

We sought to design a computer-assisted system measuring the anterior tibial translation in stress radiography, evaluate its diagnostic performance for an anterior cruciate ligament (ACL) tear, and assess factors affecting the diagnostic accuracy. Retrospective research for patients with both knee stress radiography and magnetic resonance imaging (MRI) at our institution was performed. A complete ACL rupture was confirmed on an MRI. The anterior tibial translations with four different methods were measured in 249 patients by the designed algorithm. The diagnostic accuracy of each method in patients with all successful measurements was evaluated. Univariate logistic regression analysis for factors affecting diagnostic accuracy of method four was performed. In the inclusive 249 patients, 177 patients (129 with completely torn ACLs) were available for analysis. Mean anterior tibial translations were significantly increased in the patients with a completely torn ACL by all four methods, with diagnostic accuracies ranging from 66.7% to 75.1%. The diagnostic accuracy of method four was negatively associated with the time interval between stress radiography and MRI as well as force-joint distance on stress view, and not significantly associated with age, gender, flexion angle, intercondylar distance, and force-joint angle. A computer-assisted system measuring the anterior tibial translation in stress radiography showed acceptable diagnostic performance of complete ACL injury. A shorter time interval between stress radiography and MRI as well as shorter force-joint distance were associated with higher diagnostic accuracy.

The Position of the Tibia during Graft Fixation Affects Knee Kinematics and Graft Forces for Anterior Cruciate Ligament Reconstruction

2001 ◽  
Vol 29 (6) ◽  
pp. 771-776 ◽  
Author(s):  
Jürgen Höher ◽  
Akihiro Kanamori ◽  
Jennifer Zeminski ◽  
Freddie H. Fu ◽  
Savio L-Y. Woo
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Knee Kinematics ◽  
Anterior Tibial Translation ◽  
Posterior Tibial ◽  
Anterior Tibial ◽  
Anterior Cruciate ◽  
Tibial Translation ◽  
Intact Knee

Ten cadaveric knees (donor ages, 36 to 66 years) were tested at full extension, 15°, 30°, and 90° of flexion under a 134-N anterior tibial load. In each knee, the kinematics as well as in situ force in the graft were compared when the graft was fixed with the tibia in four different positions: full knee extension while the surgeon applied a posterior tibial load (Position 1), 30° of flexion with the tibia at the neutral position of the intact knee (Position 2), 30° of flexion with a 67-N posterior tibial load (Position 3), and 30° of flexion with a 134-N posterior tibial load (Position 4). For Positions 1 and 2, the anterior tibial translation and the in situ forces were up to 60% greater and 36% smaller, respectively, than that of the intact knee. For Position 3, knee kinematics and in situ forces were closest to those observed in the intact knee. For Position 4, anterior tibial translation was significantly decreased by up to 2 mm and the in situ force increased up to 31 N. These results suggest that the position of the tibia during graft fixation is an important consideration for the biomechanical performance of an anterior cruciate ligament-reconstructed knee.

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