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Arthroscopy. 2016 Nov;32(11):2322-2328. doi: 10.1016/j.arthro.2016.03.018. Epub 2016 May 14.

The Influence of Knee Flexion Angle for Graft Fixation on Rotational Knee Stability During Anterior Cruciate Ligament Reconstruction: A Biomechanical Study.

Author information

1
Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A.
2
Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A.; Department of Mechanical Engineering and Material Science, University of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A.
3
Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A.; Department of Mechanical Engineering and Material Science, University of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A.. Electronic address: ffu@upmc.edu.

Abstract

PURPOSE:

To evaluate the effect of knee flexion angle for hamstring graft fixation, full extension (FE), or 30°, on acceleration of the knee motion during pivot-shift testing after either anatomic or nonanatomic anterior cruciate ligament (ACL) reconstruction using triaxial accelerometry.

METHODS:

Two types of ACL reconstructions (anatomic and nonanatomic) using 2 different angles of knee flexion during graft fixation (FE and 30°) were performed on 12 fresh-frozen human knees making 4 groups: anatomic-FE, anatomic-30°, nonanatomic-FE, and nonanatomic-30°. Manual pivot-shift testing was performed at ACL-intact, ACL-deficient, and ACL-reconstructed conditions. Three-dimensional acceleration of knee motion was recorded using a triaxial accelerometer.

RESULTS:

The anatomic-30° group showed the smallest overall magnitude of acceleration among the ACL-reconstructed groups (P = .0039). There were no significant differences among the anatomic-FE group, the nonanatomic-FE group, and the nonantomic-30° group (anatomic-FE vs nonanatomic-FE, P = .1093; anatomic-FE vs nonanatomic-30°, P = .8728; and nonanatomic-FE vs nonanatomic-30°, P = .1093). After ACL transection, acceleration was reduced by ACL reconstruction with the exception of the nonanatomic-FE group that did not show a significant difference when compared with the ACL-deficient (P = .4537).

CONCLUSIONS:

The anatomic ACL reconstruction with the graft fixed at 30° of knee flexion better restored rotational knee stability compared with FE. An ACL graft fixed with the knee at FE in anatomic position did not show a significant difference compared with the nonanatomic ACL reconstructions.

CLINICAL RELEVANCE:

Knee flexion angle at the time of graft fixation for ACL reconstruction can be considered to maximize the rotational knee stability.

PMID:
27189870
DOI:
10.1016/j.arthro.2016.03.018
[Indexed for MEDLINE]

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