Biomechanical comparison of three anatomic ACL reconstructions in a porcine model

Debandi, Aníbal; Maeyama, Akira; Lu, Songcen; Hume, Chad; Asai, Satoshi; Goto, Bunsei; Hoshino, Yuichi; Smolinski, Patrick; Fu, Freddie H.

doi:10.1007/s00167-010-1338-3

Cited by 36 publications

(29 citation statements)

References 64 publications

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“…Altered magnitudes in external loading could have confounded or biased the ensemble averages through increased variability. However, biomechanical tendencies in investigations with different loading magnitudes were often similar as ACLD increased ATT relative to ACL-intact knees throughout flexion under each Lachman’s and pivot-shift loads;[32, 62, 64, 66, 69, 96–101] ACLR restored ATT relative to ACLD under Lachman’s loads, but not necessarily to the level of ACL-intact knees;[62, 96, 99, 101] ACLR restored ITR relative to ACL-intact knees under rotational loads;[31, 41, 62] and ACLR graft forces were not consistent with ACL-intact ligament forces. [63–65, 99, 101] Therefore, normalized mechanical response of ACL, ACLD, and ACLR specimens generally remains constant across varied magnitudes of external loading, though absolute values may differ.…”

Section: Discussionmentioning

confidence: 99%

Anterior cruciate ligament biomechanics during robotic and mechanical simulations of physiologic and clinical motion tasks: A systematic review and meta-analysis

Bates

Myer

Shearn

et al. 2015

Clinical Biomechanics

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Investigators use in vitro joint simulations to invasively study the biomechanical behaviors of the anterior cruciate ligament. The aims of these simulations are to replicate physiologic conditions, but multiple mechanisms can be used to drive in vitro motions, which may influence biomechanical outcomes. The objective of this review was to examine, summarize, and compare biomechanical evidence related to anterior cruciate ligament function from in vitro simulations of knee motion. A systematic review was conducted (2004 to 2013) in Scopus, PubMed/Medline, and SPORTDiscus to identify peer-reviewed studies that reported kinematic and kinetic outcomes from in vitro simulations of physiologic or clinical tasks at the knee. Inclusion criteria for relevant studies were articles published in English that reported on whole-ligament anterior cruciate ligament mechanics during the in vitro simulation of physiologic or clinical motions on cadaveric knees that were unaltered outside of the anterior-cruciate-ligament-intact, -deficient, and -reconstructed conditions. A meta-analysis was performed to synthesize biomechanical differences between the anterior-cruciate-ligament-intact and reconstructed conditions. 77 studies met our inclusion/exclusion criteria and were reviewed. Combined joint rotations have the greatest impact on anterior cruciate ligament loads, but the magnitude by which individual kinematic degrees of freedom contribute to ligament loading during in vitro simulations is technique-dependent. Biomechanical data collected in prospective, longitudinal studies corresponds better with robotic-manipulator simulations than mechanical-impact simulations. Robotic simulation indicated that the ability to restore intact anterior cruciate ligament mechanics with anterior cruciate ligament reconstructions was dependent on loading condition and degree of freedom examined.

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Section: Discussionmentioning

confidence: 99%

Anterior cruciate ligament biomechanics during robotic and mechanical simulations of physiologic and clinical motion tasks: A systematic review and meta-analysis

Bates

Myer

Shearn

et al. 2015

Clinical Biomechanics

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“…However, the porcine bone model is well established in this context and was proven for its similar characteristics compared with young human knee bone [8,11,16].…”

Section: Discussionmentioning

confidence: 99%

Interference screws should be shorter than the hamstring tendon graft in the bone tunnel for best fixation

Stalder

Farshad

Snedeker

et al. 2012

Knee Surg Sports Traumatol Arthrosc

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Purpose Interference screw fixation of hamstring tendon grafts in bone has to overcome the challenges that tendons have a slippery surface and viscoelastically adapt under pressure. As the typical failure mode of the graft is to slip past the interference screw, it was hypothesized that the position and configuration of the graft end may be of influence on the fixation strength. Methods Different configurations of the graft ending and its effect to primary fixation with interference screws after viscoelastic adaptation were tested in six groups: I: graft and the screw inserted at the same depth, II/III: the graft overlaps the tip of the screw (interference screw of 28 and 19 mm in length, respectively), IV: strengthening of the graft ending with additional suture knots, V: Endopearl, respectively, and VI: effect of partial retraction of the screw after excessive insertion. In vitro tests were performed with fresh calf tendon grafts and interference screws in bone tunnels (fresh porcine distal femur) all of 8 mm in diameter. Results The relative position of the graft ending to the tip of the interference screw thereby was recognized as a significant factor on pullout forces. Further strengthening at the graft endings with additional suture knots or an Endopearl device could improve primary hold as well. Conclusions Better fixation strength is achieved if the tip of interference screw does not extend past the end of a tendon graft. Enforcement of the tendon end with sutures or an implant can further improve fixation.

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“…From the in vitro setting, the use of customdesigned robotic mechanisms ( Fig. 1) and industrial robotic manipulators has enabled researchers to standardize the magnitude and direction of forces and moments applied to the knee [19][20][21][22][23]. This has allowed the practice of repeatable forces applied to the joint under study.…”

Section: Basic Theory Of Clinical Knee Biomechanics and Objective Assmentioning

confidence: 99%

Basic biomechanic principles of knee instability

Zlotnicki

Naendrup

Ferrer

et al. 2016

Curr Rev Musculoskelet Med

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Motion at the knee joint is a complex mechanical phenomenon. Stability is provided by a combination of static and dynamic structures that work in concert to prevent excessive movement or instability that is inherent in various knee injuries. The anterior cruciate ligament (ACL) is a main stabilizer of the knee, providing both translational and rotatory constraint. Despite the high volume of research directed at native ACL function, pathogenesis and surgical reconstruction of this structure, a gold standard for objective quantification of injury and subsequent repair, has not been demonstrated. Furthermore, recent studies have suggested that novel anatomic structures may play a significant role in knee stability. The use of biomechanical principles and testing techniques provides essential objective/quantitative information on the function of bone, ligaments, joint capsule, and other contributing soft tissues in response to various loading conditions. This review discusses the principles of biomechanics in relation to knee stability, with a focus on the objective quantification of knee stability, the individual contributions of specific knee structures to stability, and the most recent technological advances in the biomechanical evaluation of the knee joint.

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Biomechanical comparison of three anatomic ACL reconstructions in a porcine model

Cited by 36 publications

References 64 publications

Anterior cruciate ligament biomechanics during robotic and mechanical simulations of physiologic and clinical motion tasks: A systematic review and meta-analysis

Anterior cruciate ligament biomechanics during robotic and mechanical simulations of physiologic and clinical motion tasks: A systematic review and meta-analysis

Interference screws should be shorter than the hamstring tendon graft in the bone tunnel for best fixation

Basic biomechanic principles of knee instability

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