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Am J Sports Med. 2002 Sep-Oct;30(5):660-6.

Biomechanical analysis of an anatomic anterior cruciate ligament reconstruction.

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  • 1Musculoskeletal Research Center, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA.

Abstract

BACKGROUND:

The focus of most anterior cruciate ligament reconstructions has been on replacing the anteromedial bundle and not the posterolateral bundle.

HYPOTHESIS:

Anatomic two-bundle reconstruction restores knee kinematics more closely to normal than does single-bundle reconstruction.

STUDY DESIGN:

Controlled laboratory study.

METHODS:

Ten cadaveric knees were subjected to external loading conditions: 1) a 134-N anterior tibial load and 2) a combined rotatory load of 5-N x m internal tibial torque and 10-N x m valgus torque. Resulting knee kinematics and in situ force in the anterior cruciate ligament or replacement graft were determined by using a robotic/universal force-moment sensor testing system for 1) intact, 2) anterior cruciate ligament deficient, 3) single-bundle reconstructed, and 4) anatomically reconstructed knees.

RESULTS:

Anterior tibial translation for the anatomic reconstruction was significantly closer to that of the intact knee than was the single-bundle reconstruction. The in situ force normalized to the intact anterior cruciate ligament for the anatomic reconstruction was 97% +/- 9%, whereas the single-bundle reconstruction was only 89% +/- 13%. With a combined rotatory load, the normalized in situ force for the single-bundle and anatomic reconstructions at 30 degrees of flexion was 66% +/- 40%and 91% +/- 35%, respectively.

CONCLUSIONS:

Anatomic reconstruction may produce a better biomechanical outcome, especially during rotatory loads.

CLINICAL RELEVANCE:

Results may lead to the use of a two-bundle technique.

Copyright 2002 American Orthopaedic Society for Sports Medicine

PMID:
12238998
[PubMed - indexed for MEDLINE]
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