Biomechanical Evaluation of Two Techniques for Double-Bundle Anterior Cruciate Ligament Reconstruction

Petersen, Wolf; Tretow, Henning; Weimann, André; Herbort, Mirco; Fu, Freddie H.; Raschke, Michael J.; Zantop, Thore

doi:10.1177/0363546506294468

Cited by 126 publications

(162 citation statements)

References 35 publications

(89 reference statements)

Supporting

Mentioning

156

Contrasting

Unclassified

Order By: Relevance

“…Much of this work has evaluated and improved the efficaciousness of surgical methods and graft material selections used in ACL reconstructions with respect to native ACL biomechanics [12,15,19,20,28,35,43,49,51,[56][57][58]. These simulations have also gathered data on the mechanical contributions of the intact ACL in response to Lachman's and pivot shift tests [15,19,20,28,35,43,49,51,[56][57][58], gait cycles [23,39], and landing impact forces [32,40,41,46,52,53]. The accrued data have advanced the knowledge of ACL function and provided a baseline of comparison by which to evaluate the effectiveness of ACL injury treatments.…”

Section: Introductionmentioning

confidence: 99%

“…It is important to accurately identify the underlying contributors to ACL loading during physiologic tasks because this knowledge could be extrapolated to improve the efficacy of injury prevention and rehabilitation techniques. Most models that have quantified mechanical contributions to ligament load and strain are constrained via a combination of force, torsional, and anatomic restrictions [5,15,19,20,28,32,35,40,41,43,46,49,[51][52][53][56][57][58]. Only limited literature is available pertaining to models of dynamic tasks that are precision constrained relative to in vivo kinematics [6][7][8][9]23].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Knee Abduction Affects Greater Magnitude of Change in ACL and MCL Strains Than Matched Internal Tibial Rotation In Vitro

Bates

Nesbitt

Shearn

et al. 2017

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background Anterior cruciate ligament (ACL) injures incur over USD 2 billion in annual medical costs and prevention has become a topic of interest in biomechanics. However, literature conflicts persist over how knee rotations contribute to ACL strain and ligament injury. To maximize the efficacy of ACL injury prevention, the effects of underlying mechanics need to be better understood. Questions/purposes We applied robotically controlled, in vivo-derived kinematic stimuli to the knee to assess ligament biomechanics in a cadaver model. We asked: (1) Does the application of abduction rotation increase ACL and medial collateral ligament (MCL) strain relative to the normal condition? (2) Does the application of internal tibial rotation impact ACL strain relative to the neutral condition? (3) Does combined abduction and internal tibial rotation increase ligament strain more than either individual contribution?Methods A six-degree-of-freedom robotic manipulator was used to position 17 cadaveric specimens free from knee pathology outside of low-grade osteoarthritis (age, 47 ± 8 years; 13 males, four females) into orientations that mimic initial contact recorded from in vivo male and female drop vertical jump and sidestep cutting activities. Four-degree rotational perturbations were applied in both directions from the neutral alignment position (creating an 8°range) for each frontal, transverse, and combined planes while ACL and MCL strains were continuously recorded with DVRT strain gauges implanted directly on each ligament. Analysis of variance models with least significant difference post hoc analysis were used to assess differences in ligament strain and joint loading between sex, ligament condition, or motion task and rotation type. Results For the female drop vertical jump simulation in the intact knee, isolated abduction and combined abduction/internal rotational stimuli produced the greatest This work was supported by National Institutes of Health/NIAMS Grants #R01-AR049735 (TEH), #R01-AR055563 (TEH), #R01-AR056660 (JTS), and #R01-AR056259 (TEH -017-5367-9 Clinical Orthopaedics and Related Research ® A Publication of The Association of Bone and Joint Surgeons® change in strain from the neutral position as compared with all other stimuli within the ACL (1.5% ± 1.0%, p B 0.035; 1.8% ± 1.3%, p B 0.005) and MCL (1.8% ± 1.0%, p \ 0.001; 1.6% ± 1.3%, p \ 0.001) compared with all other applied stimuli. There were no differences in mean peak ACL strain between any rotational stimuli (largest mean difference = 2.0%; 95% confidence interval [CI], À0.9% to 5.0%; p = 0.070). These trends were consistent for all four simulated tasks. Peak ACL strain in the intact knee was larger than peak MCL strain for all applied rotational stimuli in the drop vertical jump simulations (smallest mean difference = 2.1%; 95% CI, À0.4% to 4.5%; p = 0.047). Conclusions Kinematically constrained cadaveric knee models using peak strain as an outcome variable require greater than 4°rotational perturbations to elicit changes in intraa...

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Knee Abduction Affects Greater Magnitude of Change in ACL and MCL Strains Than Matched Internal Tibial Rotation In Vitro

Bates

Nesbitt

Shearn

et al. 2017

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

show abstract

“…A number of biomechanical [6,14,29,36] and clinical studies [1,4,17,18,22,23,26,37,39] with different techniques have been published. Improved results were reported for the double-bundle reconstruction with one tibial tunnel compared to a single-bundle reconstruction, particularly for the simulated pivot shift, but also in anterior tibial translation [6,23,36].…”

Section: Introductionmentioning

confidence: 99%

ACL double-bundle reconstruction with one tibial tunnel provides equal stability compared to two tibial tunnels

Drews

Seitz

Huth

et al. 2016

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

Tightening both bundles in ACL double-bundle reconstruction with one or two tibial tunnels in different flexion angles achieved comparable restoration of stability, although there was different load sharing on the bundles. With regard to individualized ACL reconstruction, the double-bundle technique with one tibial tunnel offers a possibility to address small tibial insertion sites without compromising the advantages of a double-bundle procedure.

show abstract

“…These have found significantly better knee stability after anatomic double-bundle reconstruction than after singlebundle and nonanatomic double-bundle reconstructions. 26,33,34 However, these biomechanical studies did not simulate clinically available procedures for ACL reconstruction, because the knee joints were widely exposed to directly identify the anatomic attachments of the 2 bundles so that the tunnel locations could be idealized. In actual arthroscopic surgery for patients, however, there is a possibility that the tunnel locations have differed among the previously reported clinical procedures.…”

mentioning

confidence: 99%

Biomechanical Comparisons of Knee Stability After Anterior Cruciate Ligament Reconstruction Between 2 Clinically Available Transtibial Procedures

et al. 2010

View full text Add to dashboard Cite

show abstract

Biomechanical Evaluation of Two Techniques for Double-Bundle Anterior Cruciate Ligament Reconstruction

Abstract: At the time of initial fixation, there appears to be a small biomechanical advantage to the second tibial tunnel in the setting of two-bundle anterior cruciate ligament reconstruction.

Cited by 126 publications

References 35 publications

Knee Abduction Affects Greater Magnitude of Change in ACL and MCL Strains Than Matched Internal Tibial Rotation In Vitro

Knee Abduction Affects Greater Magnitude of Change in ACL and MCL Strains Than Matched Internal Tibial Rotation In Vitro

ACL double-bundle reconstruction with one tibial tunnel provides equal stability compared to two tibial tunnels

Biomechanical Comparisons of Knee Stability After Anterior Cruciate Ligament Reconstruction Between 2 Clinically Available Transtibial Procedures

Contact Info

Product

Resources

About