Comparison of the ACL and ACL graft forces before and after ACL reconstruction an in-vitro robotic investigation

Li, Guoan; Papannagari, Ramprasad; DeFrate, Louis E.; Yoo, Jae Doo; Park, Sang Eun; Gill, Thomas J.

doi:10.1080/17453670610046019

Cited by 50 publications

(50 citation statements)

References 28 publications

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“…In addition, a graft placed too far anteriorly could result in a vertically oriented graft [5,9,16,25,29,56]. A vertically oriented graft is unlikely to restore the oblique orientation of the ACL [9,32,44,54] and might provide inadequate restraint to the increased internal rotation [4,12,17] and medial tibial translation [12,31] observed in patients with ACL deficiency. Altered kinematics after ACL injury are thought to predispose the knee to degenerative changes [4,17,39,40,50].…”

Section: Discussionmentioning

confidence: 99%

Reconstruction Technique Affects Femoral Tunnel Placement in ACL Reconstruction

Kaseta

DeFrate

Charnock

et al. 2008

Clinical Orthopaedics &Amp; Related Research

140

143

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Grafts placed too anteriorly on the femur are reportedly a common cause of failure in anterior cruciate ligament reconstruction. Some studies suggest more anatomic femoral tunnel placement improves kinematics. The ability of the transtibial technique and a tibial tunnel-independent technique (placed transfemorally outside-in) to place the guide pin near the center of the femoral attachment of the anterior cruciate ligament was compared in 12 cadavers. After arthroscopic placement of the guide pins, the femur was dissected and the three-dimensional geometry of the femur, anterior cruciate ligament footprint, and positions of each guide pin were measured. The transtibial guide-pin placement was 7.9 ± 2.2 mm from the center of the footprint (near its anterior border), whereas the independent technique positioned the guide pin 1.9 ± 1.0 mm from the center. The center of the footprint was within 2 mm of an anteroposterior line through the most posterior border of the femoral cartilage in the notch and a proximodistal line through the proximal margin of the cartilage at the capsular reflection. More accurate placement of the femoral tunnel might reduce the incidence of graft failure and might reduce long-term degeneration observed after reconstruction although both would require clinical confirmation.

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Section: Discussionmentioning

confidence: 99%

Reconstruction Technique Affects Femoral Tunnel Placement in ACL Reconstruction

Kaseta

DeFrate

Charnock

et al. 2008

Clinical Orthopaedics &Amp; Related Research

140

143

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“…Previous in vitro studies demonstrated that ACL provides resistance to lateral translation. 36,37 In ACL deficient knees, a lateral shift of the femur occurs relative to normal knees. 36,37 The constraining function of the ACL was lost in our PCR-TKAs, which might have caused the lateral femoral translation.…”

Section: Discussionmentioning

confidence: 99%

Kinematics of medial osteoarthritic knees before and after posterior cruciate ligament retaining total knee arthroplasty

Yue

Varadarajan

Moynihan

et al. 2010

Journal Orthopaedic Research

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Total knee arthroplasty (TKA) is a widely accepted surgical procedure for the treatment of patients with end-stage osteoarthritis (OA). However, the function of the knee is not always fully recovered after TKA. We used a dual fluoroscopic imaging system to evaluate the in vivo kinematics of the knee with medial compartment OA before and after a posterior cruciate ligament-retaining TKA (PCR-TKA) during weight-bearing knee flexion, and compared the results to those of normal knees. The OA knees displayed similar internal/external tibial rotation to normal knees. However, the OA knees had less overall posterior femoral translation relative to the tibia between 0 • and 105 • flexion and more varus knee rotation between 0 • and 45 • flexion, than in the normal knees. Additionally, in the OA knees the femur was located more medially than in the normal knees, particularly between 30 • and 60 • flexion. After PCR-TKA, the knee kinematics were not restored to normal. The overall internal tibial rotation and posterior femoral translation between 0 • and 105 • knee flexion were dramatically reduced. Additionally, PCR-TKA introduced an abnormal anterior femoral translation during early knee flexion, and the femur was located lateral to the tibia throughout weight-bearing flexion. The data help understand the biomechanical functions of the knee with medial compartment OA before and after contemporary PCR-TKA. They may also be useful for improvement of future prostheses designs and surgical techniques in treatment of knees with end-stage OA.

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“…Failure to incorporate joint structural contributions to resultant 3D joint and ligament load states may also lead to erroneous interpretations of injury risk via a sagittal loading mecha nism. A large posterior tibial slope for example, viewed to occur more frequently in women (Brandon et al, 2006), will likely promote increases in anteriorly directed tibial loads, and further orient the ACL such that a greater portion of this load is transferred along the ligament (Li et al, 2006;Petersen and Zantop, 2007). Expanding cur rent models to incorporate an anatomically relevant knee joint (Pflum et al, 2004;Shelburne et al, 2004) capable of accommodating subject-based variations in knee anato mies and laxities would provide immediate insights into individual predispositions to ACL injury based on joint and tissue biomechanical vulnerabilities.…”

Section: Discussionmentioning

confidence: 99%