Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction Using Hamstring Tendons With Minimally Required Initial Tension

Effect of graft tensioning on mechanical restoration in a rat model of anterior cruciate ligament reconstruction using free tendon graft

“…Further improvement in standardization of the neutral position will be favourable. As 6 weeks in adult rat was roughly equivalent to 4 years in human [14], the maximum observation time in this study was similar to the follow-up period in previous clinical studies of graft pre-tensioning [7,9,11]. Yet, further study with a longer follow-up may be necessary for studies of ligamentization and chondral lesions.…”

Anatomic double-bundle anterior crucial ligament reconstruction with G-ST

“…They estimated that 7.3 N was the laxity match pretension compared with normal knee in the anatomic double-bundle ACL reconstruction [71]. Based on the results, they performed ACL reconstruction with 20 N as initial tension and reported good clinical outcomes at 2 years post-operatively [72]. Therefore, they recommended using such a relative low tension as an initial tension for anatomic double-bundle reconstruction.…”

Effect of Initial Graft Tension on Knee Stability and Graft Tension Pattern in Double-Bundle Anterior Cruciate Ligament Reconstruction

“…6,7 One of the main reasons for the discrepancy in the clinical results might be differences in initial graft tension in double-bundle ACL reconstruction because no consensus exists on the optimal setting of initial graft tension in the AMB and PLB. [8][9][10][11] It has been reported that excessive initial tension might lead to over-constraining the knee joint, resulting in loss of range of motion, graft failure, or articular cartilage degeneration in single-bundle ACL reconstruction. [12][13][14][15] Therefore some studies have focused on the laxity match pre-tensiondwhich is the minimal required tension to restore normal laxity compared with the healthy kneedto determine the optimal setting of the initial tension.…”

“…Mae et al 16 showed in their cadaveric study that the laxity match pre-tension in anatomic double-bundle ACL reconstruction was 7.3 N. They also reported that 20 N of the initial tension was high enough to yield good clinical outcomes at 2 years after surgery. 10 However, the laxity match pre-tension has been determined only by anteroposterior laxity in cadaveric studies. In addition, there has been no study evaluating the effect of initial graft tension on knee stability, especially rotational stability, and the graft tension pattern in double-bundle ACL reconstruction during surgery.…”