Biomechanical evaluation of anatomic single- and double-bundle anterior cruciate ligament reconstruction techniques using the quadriceps tendon

Kim, Donghwi; Asai, Satoshi; Moon, Chan-Woong; Hwang, Sun‐Chul; Lee, Sahnghoon; Keklikçi, Kenan; Linde-Rosen, Monica; Smolinski, Patrick; Fu, Freddie H.

doi:10.1007/s00167-014-3462-y

Cited by 30 publications

(31 citation statements)

References 41 publications

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“…The MM posterior shift is probably associated with losing the meniscal function as a secondary stabiliser. ACL reconstruction is well known to be effective in repressing abnormal anterior tibial translation [14,16]. In addition, some biomechanical studies demonstrated that ACL reconstructions could change the contact areas and pressures of the tibiofemoral joint postoperatively [11,22].…”

Section: Discussionmentioning

confidence: 99%

Meniscal repair concurrent with anterior cruciate ligament reconstruction restores posterior shift of the medial meniscus in the knee-flexed position

Okazaki

Furumatsu

Miyazawa

et al. 2018

Knee Surg Sports Traumatol Arthrosc

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The purpose of this study was to evaluate the shape and shift of the medial meniscus before and after meniscal repair concurrent with ACL reconstruction using magnetic resonance imaging (MRI) at 90° of knee flexion. Methods: This study included 18 patients with ACL-deficient knees without meniscus tears (group A), 11 patients with medial meniscus tears alone (group M), and 15 patients with ACL-deficient knees complicated with medial meniscus tears (group AM). The posterior segment shape was evaluated using open MRI at 90° of knee flexion preoperatively and at 3 months postoperatively. The length, height, width, and posterior extrusion of the medial meniscus and posterior tibiofemoral distance were measured. These measurements were compared between the three groups. Results: On preoperative MRI, a significant difference was observed in the posterior extrusion of the medial meniscus (group A, 1.2±0.5 mm; group M, 1.7±0.3 mm; group AM, 4.1±1.5 mm, p<0.001). All parameters did not differ between the three groups on postoperative MRI. In addition, the posterior width and extrusion of the medial meniscus were decreased significantly after meniscal repair concurrent with ACL reconstruction. Conclusion: This study demonstrated that the medial meniscus shifted posteriorly at 90° of knee 2 flexion in ACL-deficient knees complicated with medial meniscus tears. Medial meniscal repair concurrent with ACL reconstruction improved the deformed morphology and posterior extrusion. MRI measurements of the posterior extrusion at the knee-flexed position may be clinically useful to assess the functional improvement of the medial meniscus following meniscal repair combined with ACL reconstruction.

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Section: Discussionmentioning

confidence: 99%

Meniscal repair concurrent with anterior cruciate ligament reconstruction restores posterior shift of the medial meniscus in the knee-flexed position

Okazaki

Furumatsu

Miyazawa

et al. 2018

Knee Surg Sports Traumatol Arthrosc

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“…Three‐dimensional evaluation of joint stability is a contemporary method to evaluate joint kinematics for purposes of diagnosis and treatment efficacy . It is also important to assess joint stability under conditions intended to replicate joint dynamics during the normal step cycle as exemplified by quantification of angular displacement during application of translational force to the tibia performed in this investigation . Techniques used to quantify rotation and translation in this study have been previously validated in the canine stifle .…”

Section: Discussionmentioning

confidence: 99%

“…The goal of eliminating abnormal tibial translation and rotation following CrCL graft reconstruction is a perpetual challenge of orthopedic surgery since joint instability is strongly associated with progressive joint disease . Suture elongation can lead to canine stifle instability following extracapsular stabilization, joint rotational stability is not fully restored by current extra‐articular and osteotomy techniques, and contemporary extra‐articular prosthetic stabilizations do not result in normal joint kinematics despite acceptable functional outcomes .…”

Section: Discussionmentioning

confidence: 99%

“…Tissue composition, fixation, and biologic incorporation affect cruciate graft reconstruction strength as well as joint kinematics . Optimization of femoral graft bone tunnel orientation and fixation site location are a major focus of human orthopedic research as it strongly impacts joint laxity, graft tension patterns, and joint kinematics . In one report, normal function was achieved in less than 15% of Labrador Retrievers treated for CrCL rupture with partial or complete medial meniscectomy and medial patellar tendon grafts passed over‐the‐top of the lateral femoral condyle, lateral suture stabilization, or tibial plateau leveling osteotomy .…”

Section: Introductionmentioning

confidence: 99%

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Joint stability after canine cranial cruciate ligament graft reconstruction varies among femoral fixation sites

et al. 2017

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“…From a biomechanical standpoint, tensile tests demonstrated that cross-sectional area of the quadriceps tendon graft was nearly twice that of the bone-patellabone graft with ultimate load to failure, and stiffness was also significantly higher for the QT graft. Recent in vitro study demonstrated quadriceps tendon to restore native kinematics to an ACL-deficient knee, with double-bundle quadriceps tendon restoring in situ ACL graft forces to more similar than that of the intact ACL [74].…”

Section: The Restoration Of Knee Kinematics; Individualized Acl Surgerymentioning

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 evaluation of anatomic single- and double-bundle anterior cruciate ligament reconstruction techniques using the quadriceps tendon

Abstract: DB ACL reconstruction using quadriceps tendon can restore biomechanics of the knee to that of the intact ACL regardless of whether three or four tunnels are used, but SB reconstruction does not.

Cited by 30 publications

References 41 publications

Meniscal repair concurrent with anterior cruciate ligament reconstruction restores posterior shift of the medial meniscus in the knee-flexed position

Meniscal repair concurrent with anterior cruciate ligament reconstruction restores posterior shift of the medial meniscus in the knee-flexed position

Joint stability after canine cranial cruciate ligament graft reconstruction varies among femoral fixation sites

Basic biomechanic principles of knee instability

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