Posterior Tibial Slope Influences Static Anterior Tibial Translation in Anterior Cruciate Ligament Reconstruction

2014 ◽  
Vol 42 (4) ◽  
pp. 927-933 ◽  
Author(s):  
Yue Li ◽  
Lei Hong ◽  
Hua Feng ◽  
Qianqian Wang ◽  
Jin Zhang ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Tibial Slope ◽  
Anterior Tibial Translation ◽  
Cruciate Ligament Reconstruction ◽  
Posterior Tibial ◽  
Anterior Tibial ◽  
Anterior Cruciate ◽  
Tibial Translation

The Effect of Anterior Cruciate Ligament Reconstruction on Knee Joint Kinematics under Simulated Muscle Loads

2005 ◽  
Vol 33 (2) ◽  
pp. 240-246 ◽  
Author(s):  
Jae Doo Yoo ◽  
Ramprasad Papannagari ◽  
Sang Eun Park ◽  
Louis E. DeFrate ◽  
Thomas J. Gill ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Anterior Tibial Translation ◽  
Cruciate Ligament Reconstruction ◽  
Anterior Tibial ◽  
Anterior Cruciate ◽  
Tibial Translation ◽  
Reconstructed Knee

Background Numerous studies have investigated anterior stability of the knee during the anterior drawer test after anterior cruciate ligament reconstruction. Few studies have evaluated anterior cruciate ligament reconstruction under physiological loads. Purpose To determine whether anterior cruciate ligament reconstruction reproduced knee motion under simulated muscle loads. Study Design Controlled laboratory study. Methods Eight human cadaveric knees were tested with the anterior cruciate ligament intact, transected, and reconstructed (using a bone–patellar tendon–bone graft) on a robotic testing system. Tibial translation and rotation were measured at 0 °, 15 °, 30 °, 60 °, and 90 ° of flexion under anterior drawer loading (130 N), quadriceps muscle loading (400 N), and combined quadriceps and hamstring muscle loading (400 N and 200 N, respectively). Repeated-measures analysis of variance and the Student-Newman-Keuls test were used to detect statistically significant differences between knee states. Results Anterior cruciate ligament reconstruction resulted in a clinically satisfactory anterior tibial translation. The anterior tibial translation of the reconstructed knee was 1.93 mm larger than the intact knee at 30 ° of flexion under anterior load. Anterior cruciate ligament reconstruction overconstrained tibial rotation, causing significantly less internal tibial rotation in the reconstructed knee at low flexion angles (0 °-30 °) under muscle loads (P<. 05). At 30 ° of flexion, under muscle loads, the tibia of the reconstructed knee was 1.9 ° externally rotated compared to the intact knee. Conclusions Anterior cruciate ligament reconstruction may not restore the rotational kinematics of the intact knee under muscle loads, even though anterior tibial translation was restored to a clinically satisfactory level under anterior drawer loads. These data suggest that reproducing anterior stability under anterior tibial loads may not ensure that knee joint kinematics is restored under physiological loading conditions. Clinical Relevance Decreased internal rotation of the knee after anterior cruciate ligament reconstruction may lead to increased patellofemoral joint contact pressures. Future anterior cruciate ligament reconstruction techniques should aim at restoring 3-dimensional knee kinematics under physiological loads.

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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