title: Tibial rotation is not restored after ACL reconstruction with a hamstring graft.
abstract: Recent research suggests ACL reconstruction does not restore tibial rotation to normal levels during high demand activities when a bone-patellar tendon-bone graft is used. We asked if an alternative graft, the semitendinosus-gracilis (ST/G) tendon graft, could restore tibial rotation during a high demand activity. Owing to its anatomic similarity with the normal ACL we hypothesized the ST/G graft could restore excessive tibial rotation to normal healthy levels along with a successful reinstatement of the clinical stability of the knee. We assessed tibial rotation in vivo, using gait analysis. We compared the knees of ACL reconstructed patients with an ST/G graft to their intact contralateral and healthy controls during a pivoting task that followed a stair descent. We also evaluated knee stability after ACL reconstruction with standard clinical tests. ACL reconstruction with the ST/G graft and with current techniques did not restore tibial rotation to previous physiological levels during an activity with increased rotational loading at the knee, although abnormal anteroposterior (AP) tibial translation was restored.
authors.affiliation: Orthopaedic Sports Medicine Center of Ioannina, Department of Orthopaedic Surgery, University of Ioannina, Ioannina, Greece.
authors.forename: Anastasios D
authors.initials: AD
authors.lastname: Georgoulis
authors.forename: Stavros
authors.initials: S
authors.lastname: Ristanis
authors.forename: Vasileios
authors.initials: V
authors.lastname: Chouliaras
authors.forename: Constantina
authors.initials: C
authors.lastname: Moraiti
authors.forename: Nicholas
authors.initials: N
authors.lastname: Stergiou
mesh_terms: D000328:Adult; D016118:Anterior Cruciate Ligament / Q000503:physiopathology / Q000601:surgery*; D016022:Case-Control Studies; D005684:Gait / Q000502:physiology; D006801:Humans; D007593:Joint Instability / Q000503:physiopathology; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery; D008297:Male; D019637:Orthopedic Procedures / Q000379:methods*; D016059:Range of Motion, Articular / Q000502:physiology*; D013710:Tendons / Q000637:transplantation*; D013977:Tibia / Q000502:physiology*; D016896:Treatment Outcome