The effect of soft-tissue graft fixation in anterior cruciate ligament reconstruction on graft-tunnel motion under anterior tibial loading

Biomechanics of knee ligaments: injury, healing, and repair

“…Shortening the tape length from 35 to 15 mm could significantly reduce the motion by 33%, as 90% of this elongation resulted from the tape. A further study revealed that a graft secured by a biodegradable interference screw can shorten the effective length of the graft, thus minimizing the amount of graft-tunnel motion (Tsuda et al, 2002).…”

Evaluation of a behind-remnant approach for femoral tunnel creation in remnant-preserving double-bundle anterior cruciate ligament reconstruction — Comparison with a standard approach

“…This might overconstrain the reconstructed knee, causing loss of extension or graft retear [44]. Nevertheless, we still think it is reasonable to create the femoral tunnels somewhat posterior to the native direct insertion site, by aiming at the posterior margin of the direct insertion for the center of the tunnels, especially when using soft-tissue grafts, considering tunnel expansion and graft deviation [45,46]. Although the knee stability immediately after surgery was not different between the two groups, further follow-up studies are needed to verify the validity of the posteriorly placed femoral tunnel.…”

“…As already mentioned above, this model does not consider any changes that might occur after the surgery, such as tunnel-graft healing, tunnel expansion, graft remodeling, and graft relaxation. In particular, tunnel expansion should be considered when a soft-tissue graft such as the hamstring is used [45,46]. Further investigations such as long-term follow-up studies of this case series, or even randomized control trials should be considered to determine optimal tunnel position for double-bundle ACL reconstructions.…”

A prospective comparison of double- and single-bundle anterior cruciate ligament reconstructions

“…Taèiau tikros prieþastys vis dar neaiðkios. Biomechaniniai tyrimai parodo, kad dviejø pluoðtø PKR rekonstrukcija uþtikrina didesná rotaciná stabilumà nei vieno pluoðto rekonstrukcija, nors visi palyginimai atlikti taikant vieno priekinio vidinio pluoðto PKR rekonstrukcijà, kuri nëra anatominë, todël su mûsø tyrimo duomenimis palyginti neámanoma (2,3,5,6,(16)(17)(18)(19)(20).…”