Application of a new positioning device for isometric replacement in anterior cruciate ligament repair and reconstruction.
The functional effects of displacing the cruciate ligament attachments were studied in ten adult cadaver knees. On a systematic variation of the femoral and tibial attachment sites according to a three-dimensional raster scheme, a quantitative analysis of the absolute length and of motion-dependent changes in ligament isometry was performed. All insertion points deviating from the original anatomic landmarks did not accomplish biomechanical requirements. A femoral displacement had an increased effect on disturbing isometry compared to a tibial malposition. Although recommended by several authors, the "over-the-top" position gave the most unsatisfactory results with a maximum isometry failure of 10 mm. In cruciate ligament replacement a positioning guide with isometry testing capacity should be mandatory to ensure correct placement of bone tunnels. For this purpose a new positioning device which allows for isometry measurements before a bone channel is drilled is introduced and applied in an experimental setup.
Raunest
J
J
Department of Surgery A, Heinrich-Heine-University Duesseldorf, F.R.G.
D000368:Aged; D016118:Anterior Cruciate Ligament / Q000033:anatomy & histology / Q000502:physiology / Q000601:surgery*; D001696:Biomechanical Phenomena; D005269:Femur / Q000033:anatomy & histology / Q000601:surgery; D006801:Humans; D066298:In Vitro Techniques; D007537:Isometric Contraction; D013525:Surgical Instruments; D013977:Tibia / Q000033:anatomy & histology / Q000601:surgery