title: Does the posterolateral bundle influence rotational movement more than the anteromedial bundle in anterior cruciate ligament reconstruction?: a clinical study.
abstract: The biomechanical function of the anteromedial   (AM) and posterolateral (PL) bundles of the anterior cruciate ligament   (ACL) remains controversial. Some studies report that the AM bundle   stabilises the knee joint in anteroposterior (AP) translation and   rotational movement (both internal and external) to the same extent   as the PL bundle. Others conclude that the PL bundle is more important   than the AM in controlling rotational movement. The objective of this randomised cohort study involving 60 patients   (39 men and 21 women) with a mean age of 32.9 years (18 to 53) was   to evaluate the function of the AM and the PL bundles of the ACL   in both AP and rotational movements of the knee joint after single-bundle   and double-bundle ACL reconstruction using a computer navigation   system. In the double-bundle group the patients were also randomised   to have the AM or the PL bundle tensioned first, with knee laxity   measured after each stage of reconstruction. All patients had isolated   complete ACL tears, and the presence of a meniscal injury was the   only supplementary pathology permitted for inclusion in the trial.   The KT-1000 arthrometer was used to apply a constant load to evaluate   the AP translation and the rolimeter was used to apply a constant   rotational force. For the single-bundle group deviation was measured   before and after ACL reconstruction. In the double-bundle group   deviation was measured for the ACL-deficient, AM- or PL-reconstructed   first conditions and for the total reconstruction. We found that the AM bundle in the double-bundle group controlled   rotation as much as the single-bundle technique, and to a greater   extent than the PL bundle in the double-bundle technique. The double-bundle   technique increases AP translation and rotational stability in internal   rotation more than the single-bundle technique.
authors.affiliation: General Hospital, Department of Orthopaedic and Traumatologic Surgery, Jana Janského 11, Znojmo 66902, Czech Republic. komzak@centrum.cz
authors.forename: M
authors.initials: M
authors.lastname: Komzák
authors.forename: R
authors.initials: R
authors.lastname: Hart
authors.forename: F
authors.initials: F
authors.lastname: Okál
authors.forename: A
authors.initials: A
authors.lastname: Safi
mesh_terms: D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000503:physiopathology*; D059549:Anterior Cruciate Ligament Reconstruction; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000503:physiopathology / Q000601:surgery*; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D012399:Rotation; D013238:Stereotaxic Techniques; D055815:Young Adult