title: Influence of bundle diameter and attachment point on kinematic behavior in double bundle anterior cruciate ligament reconstruction using computational model.
abstract: A protocol to choose the graft diameter attachment point of each bundle has not yet been determined since they are usually dependent on a surgeon's preference. Therefore, the influence of bundle diameters and attachment points on the kinematics of the knee joint needs to be quantitatively analyzed. A three-dimensional knee model was reconstructed with computed tomography images of a 26-year-old man. Based on the model, models of double bundle anterior cruciate ligament (ACL) reconstruction were developed. The anterior tibial translations for the anterior drawer test and the internal tibial rotation for the pivot shift test were investigated according to variation of bundle diameters and attachment points. For the model in this study, the knee kinematics after the double bundle ACL reconstruction were dependent on the attachment point and not much influenced by the bundle diameter although larger sized anterior-medial bundles provided increased stability in the knee joint. Therefore, in the clinical setting, the bundle attachment point needs to be considered prior to the bundle diameter, and the current selection method of graft diameters for both bundles appears justified.
authors: Department of Orthopaedic Surgery, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon 301-723, Republic of Korea.
authors: Oh Soo
authors: OS
authors: Kwon
authors: Department of Mechanical Engineering, Kyung Hee University, Yongin 446-701, Republic of Korea.
authors: Tserenchimed
authors: T
authors: Purevsuren
authors: Department of Applied Mathematics, Kyung Hee University, Yongin 446-701, Republic of Korea.
authors: Kyungsoo
authors: K
authors: Kim
authors: Department of Mechanical Engineering, Kyung Hee University, Yongin 446-701, Republic of Korea.
authors: Won Man
authors: WM
authors: Park
authors: Division of Biomedical Engineering, Chonbuk National University, Jeonju 561-756, Republic of Korea.
authors: Tae-Kyu
authors: TK
authors: Kwon
authors: Department of Mechanical Engineering, Kyung Hee University, Yongin 446-701, Republic of Korea.
authors: Yoon Hyuk
authors: YH
authors: Kim
mesh_terms: D000328:Adult; D000465:Algorithms; D016118:Anterior Cruciate Ligament / Q000502:physiology; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D001696:Biomechanical Phenomena; D003198:Computer Simulation; D005269:Femur / Q000000981:diagnostic imaging; D005360:Fibula / Q000000981:diagnostic imaging; D006801:Humans; D007593:Joint Instability / Q000601:surgery; D007719:Knee Joint / Q000503:physiopathology* / Q000601:surgery; D008297:Male; D008953:Models, Anatomic; D012399:Rotation; D012984:Software; D013977:Tibia / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed / Q000379:methods