Strain pattern comparison of double- and single-bundle anterior cruciate ligament reconstruction techniques with the native anterior cruciate ligament.
OBJECTIVE
The purpose of this study was to dynamically assess the native strain patterns of the anteromedial bundle (AMB) and posterolateral bundle (PLB) of the anterior cruciate ligament (ACL) and compare these findings with graft bundle strain patterns after double-bundle (DB) ACL reconstruction with tibial fixation under 40 N of tension at 75 degrees knee flexion (AMB) and under 20 N of tension at 20 degrees knee flexion (PLB) and after single-bundle (SB) reconstruction with tibial fixation under 40 N of tension at 20 degrees knee flexion.


METHODS
The mean strain pattern of the AMB and PLB of the native ACL of 4 cadaveric knees was measured via differential variable reluctance transducers and 2-dimensional kinematic analysis during passive manual knee flexion-extension under a constant axial compression load. Measurements were repeated after DB and SB ACL reconstruction. Celeration line assessments with a split-middle technique were performed to quantify percent strain/knee flexion-extension angle change at reciprocating bundle function transition points.


RESULTS
The DB ACL reconstruction technique displayed reciprocating AMB and PLB strain patterns that more closely replicated those of the native ACL. The SB ACL reconstruction technique tended to replicate AMB strain patterns, suggesting poor bundle function differentiation.


CONCLUSIONS
The DB ACL reconstruction with differential AMB and PLB tensioning more closely replicated native ACL strain patterns than the SB ACL reconstruction. The SB ACL reconstruction that we used closely simulated native ACL AMB strain patterns; however, PLB function was not restored.


CONCLUSIONS
The DB ACL reconstruction more closely replicated the AMB and PLB strain patterns of the native ACL.
Belisle
Adelle L
AL
University of Connecticut Health Center, Farmington, Connecticut, USA.
Bicos
James
J
Geaney
Lauren
L
Andersen
Matthew H
MH
Obopilwe
Elifho
E
Rincon
Lina
L
Nyland
John
J
Morgan
Craig
C
Caborn
David N M
DN
Arciero
Robert A
RA
D000369:Aged, 80 and over; D016118:Anterior Cruciate Ligament / Q000502:physiology* / Q000601:surgery*; D001696:Biomechanical Phenomena; D002102:Cadaver; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000502:physiology* / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D013314:Stress, Mechanical