Biomechanical analysis of an anatomic anterior cruciate ligament reconstruction.
BACKGROUND
The focus of most anterior cruciate ligament reconstructions has been on replacing the anteromedial bundle and not the posterolateral bundle.


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


METHODS
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.


CONCLUSIONS
Results may lead to the use of a two-bundle technique.
Yagi
Masayoshi
M
Musculoskeletal Research Center, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA.
Wong
Eric K
EK
Kanamori
Akihiro
A
Debski
Richard E
RE
Fu
Freddie H
FH
Woo
Savio L-Y
SL
D000704:Analysis of Variance; D016118:Anterior Cruciate Ligament / Q000033:anatomy & histology / Q000601:surgery*; D001696:Biomechanical Phenomena; D002102:Cadaver; D006801:Humans