title: Kinematic in-vitro comparison between the normal knee and two techniques for reconstruction of the anterior cruciate ligament.
abstract: The influence of anterior cruciate ligament sectioning and the results of its reconstruction on joint kinematics were studied using eight cadaver knees and a computerized system for analysis of three-dimensional motions. A Dacron(®) prosthesis was used in a transcondylar isometric drill-guide-determined route, and in an over-the-top route. After sectioning of the anterior cruciate ligament, the tibial motion increased in several passive laxity tests including anterior/posterior translation as well as varus/valgus and internal/external rotation. Increased valgus rotation was also seen during a simulated active extension manoeuvre. The effect of anterior cruciate ligament reconstruction was seen only on anterior/posterior translation, where the drill-guide technique restored, and the over-the-top technique partially restored, normal sagittal play at 90° of knee flexion. At 30° of knee flexion both methods reduced, but did not normalize, anterior/posterior translation. An adverse effect of both techniques, more prominent with the drill-guide technique which involved an extensive notchplasty, was abnormal external tibia[ rotation in 90° of knee flexion with the tibia in a gravity-determined position. Both techniques resulted in less than normal external rotation in the screw-home mechanism.
authors.affiliation: Sports Trauma Research Group, Department of Orthopaedic Surgery, University Hospital, Linköping, Sweden.
authors.forename: L
authors.initials: L
authors.lastname: Good
authors.forename: M J
authors.initials: MJ
authors.lastname: Askew
authors.forename: A
authors.initials: A
authors.lastname: Boom
authors.forename: A
authors.initials: A
authors.lastname: Melby