title: PCL to graft impingement pressure after anatomical or non-anatomical single-bundle ACL reconstruction.
abstract: BACKGROUND
  Anterior cruciate ligament (ACL) graft impingement against the posterior cruciate ligament (PCL) has been postulated, but not thoroughly investigated.
  
  
  OBJECTIVE
  To evaluate PCL impingement pressure and biomechanical stability with different tibial and femoral tunnel positions in ACL reconstruction.
  
  
  METHODS
  In 15 porcine knees, the impingement pressure between ACL and PCL was measured using pressure sensitive film before and after ACL single-bundle reconstruction. ACL reconstructions were performed in each knee with three different tibial and femoral tunnel position combinations: (1) tibial antero-medial (AM) tunnel to femoral AM tunnel (AM-AM), (2) tibial postero-lateral (PL) tunnel to femoral High-AM tunnel (PL-High-AM) and (3) tibial AM tunnel to femoral High-AM tunnel (AM-High-AM). Anterior tibial translation (ATT) was evaluated after each ACL reconstruction using robotic/universal force-moment sensor testing system.
  
  
  RESULTS
  There was no significant difference of the impingement pressure between AM and AM, PL-High-AM reconstructed groups and intact ACL. Only AM-High-AM ACL reconstruction group showed significantly higher impingement pressure compared with intact ACL. With regard to ATT, AM-AM group had significantly higher stiffness than PL-High-AM group.
  
  
  CONCLUSIONS
  Anatomical ACL reconstruction does not cause PCL impingement and it has biomechanical advantage in ATT when compared with non-anatomical ACL reconstructions in porcine knee. For the clinical relevance, in the anatomical ACL reconstruction, no ACL-PCL impingement is found.
authors.affiliation: Division of Rehabilitation Medicine, Gunma University Hospital, Showa-Machi 3-39-15, Maebashi City, Gunma, 371-8511, Japan. sekaiwoseisu@yahoo.co.jp
authors.forename: Takanori
authors.initials: T
authors.lastname: Iriuchishima
authors.forename: Goro
authors.initials: G
authors.lastname: Tajima
authors.forename: Sheila J M
authors.initials: SJ
authors.lastname: Ingham
authors.forename: Kenji
authors.initials: K
authors.lastname: Shirakura
authors.forename: Freddie H
authors.initials: FH
authors.lastname: Fu
mesh_terms: D000818:Animals; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D001696:Biomechanical Phenomena; D007593:Joint Instability; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery*; D016119:Posterior Cruciate Ligament / Q000601:surgery*; D011312:Pressure; D013552:Swine; D019737:Transplants