Loss of Knee Extension After Anterior Cruciate Ligament Reconstruction

Pretensioning of Soft Tissue Grafts in Anterior Cruciate Ligament Reconstruction

“…Extrinsic factors, such as the graft fixation method, tunnel expansion, and knee flexion angle, also must be considered. 4,10,13,15,31 Thus, attempting to replicate an exact resting tension may be futile and unnecessary.…”

“…Countless techniques have been described to replicate and maintain an adequate amount of tension across the graft after reconstruction. 6,9,[13][14][15]32 Recommend-ed initial tension has ranged from 16 to 90 N for patella tendon grafts and 70 to 80 N for hamstring grafts. 14,25 Although patella tendon grafts are not typically pretensioned outside of the knee, there is no clear consensus on the ideal tensioning protocol for hamstring tendons.…”

“…6,12 Tensioning on the graft preparation board has been reported with values ranging from 44 to 88 N (10 to 20 lb) for 10 to 30 minutes. 3,7,10,[13][14][15][16] Not all groups underwent pretensioning, and to reduce the number of variables affecting the results, the current study used the same fixation method throughout the groups. This approach allowed the authors to examine solely tendon behavior.…”

Long‐term outcome of an intra‐articular allograft technique for treatment of spontaneous cranial cruciate ligament rupture in the dog

“…One method relies on bone tunnels, but their ideal placement. In humans, bone tunnel placed at the footprints of the CCL may not be perfectly isometric, and the isometric location may be caudal to the origin of the CCL in dogs . Medial femoral transfix reconstruction with a DDFT allograft, tibial spiked washers, and an interference screw, reproduced the salient mechanical properties of the native CCL .…”

Static tensioning promotes hamstring tendons force relaxation more reliably than cycling tensioning

“…Clinically, undertensioning the graft could lead to the risk of residual laxity after implantation. This must be balanced against the risk of overconstraining the knee, which may lead to pathologic stresses on the articular cartilage, graft failure, or infrapatellar contracture [9,10].…”