The Role of the Anteromedial and Posterolateral Bundles of the Anterior Cruciate Ligament in Anterior Tibial Translation and Internal Rotation

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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Reduced anterior tibial translation associated with adaptive changes in the anterior cruciate ligament-deficient joint: Goat model

Journal of Orthopaedic Research® ◽

10.1002/jor.1100170604 ◽

1999 ◽

Vol 17 (6) ◽

pp. 810-816 ◽

Cited By ~ 13

Author(s):

Douglas W. Jackson ◽

Paul Schreck ◽

Scott Jacobson ◽

Timothy M. Simon

Keyword(s):

Anterior Cruciate Ligament ◽

Cruciate Ligament ◽

Anterior Tibial Translation ◽

Adaptive Changes ◽

Anterior Tibial ◽

Anterior Cruciate ◽

Tibial Translation ◽

Anterior Cruciate Ligament Deficient

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The Effectiveness of Reconstruction of the Anterior Cruciate Ligament Using the Novel Knot/Press-Fit Technique

The American Journal of Sports Medicine ◽

10.1177/0363546504271745 ◽

2005 ◽

Vol 33 (6) ◽

pp. 856-863 ◽

Cited By ~ 20

Author(s):

Robert H.P. Kilger ◽

Maribeth Thomas ◽

Scott Hanford ◽

Dimosthenis A. Alaseirlis ◽

Hans H. Paessler ◽

...

Keyword(s):

Anterior Cruciate Ligament ◽

Cruciate Ligament ◽

Knee Kinematics ◽

Hamstring Tendon ◽

Anterior Tibial Translation ◽

Press Fit ◽

Anterior Tibial ◽

Tendon Grafts ◽

Anterior Cruciate ◽

Tibial Translation

Background A variety of fixation devices are used for anterior cruciate ligament reconstruction with hamstring tendon grafts. These devices increase costs and can present artifacts in magnetic resonance imaging as well as complications in revision surgery. Therefore, a novel knot/press-fit technique that requires no implantable devices has been introduced. Null Hypothesis The knot/press-fit technique restores knee kinematics as well as the more commonly used EndoButton CL fixation and has similar biomechanical properties as other devices published in the literature. Study Design Controlled laboratory study. Methods Eight fresh-frozen cadaveric knees (52 ± 7 years) were tested using a robotic/universal force-moment sensor testing system. The knee kinematics of the intact, anterior cruciate ligament-deficient, EndoButton-reconstructed, and knot/pressfit-reconstructed knee in response to both a 134-N anterior tibial load and a combined rotatory load at multiple knee flexion angles was determined. Differences between the 4 knee states were evaluated with a 2-factor repeated-measures analysis of variance (P <. 05). To determine the stiffness and strength of the knot/press-fit fixation, the femur-graft-tibia complex was tested in uniaxial tension. Results In response to an anterior tibial load, the anterior tibial translation for the knot/press-fit reconstruction was found to be not significantly different from that of the intact anterior cruciate ligament as well as that of the EndoButton reconstruction (P >. 05). In response to a combined rotatory load, neither reconstruction procedure could effectively reduce the coupled anterior tibial translation to that of the intact knee, and no significant difference between the 2 reconstructions could be detected (P >. 05). The stiffness of the knot/press-fit complex was found to be 37.8 ± 9.6 N/mm, and the load at failure was 540 ± 97.7 N, which is equal to other devices published in the literature. Clinical Relevance The experiment suggests that the knot/press-fit technique may be a reliable alternative for the femoral fixation of hamstring tendon grafts.

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