title: Anteromedial and posterolateral graft kinematics of a double-bundle ACL reconstruction: a 3D computer simulation.
abstract: BACKGROUND
  The posterolateral graft has been reported to fail more frequently than the anteromedial graft in double-bundle ACL reconstructions. This study investigated the graft kinematics using a 3D modelling technique.
  
  
  METHODS
  Twenty subjects performed a stair-ascending activity under dual fluoroscopy surveillance. A double-bundle ACL reconstruction was simulated on those healthy knees using an anteromedial portal technique. The graft-tunnel interaction was described using the graft-tunnel angle and the range of the graft-tunnel edge contact (GTEC).
  
  
  RESULTS
  The femoral graft-tunnel angle of the anteromedial/posterolateral graft was 97.6 ± 7.5/100.7 ± 7.7° and the tibial graft-tunnel angle was 158.8 ± 6.5/146.5 ± 8.9° at knee extension. The femoral GTEC ranges were 23.2 ± 5.3-28.1 ± 7.6° for both grafts and the tibial GTEC ranges were 27.3 ± 2.2-34.5 ± 2.1° during stair-ascending.
  
  
  CONCLUSIONS
  The femoral graft-tunnel angle was larger than on the tibial side and the GTEC angles influenced the PL graft more, implying that grafts may experience a less optimal biomechanical environment at the femoral tunnels.
authors: Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA.|Department of Orthopaedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University, 600 Yishan Road, Shanghai, 200233, China.
authors: Xudong
authors: X
authors: Liu
authors: Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA.
authors: Jing-Sheng
authors: JS
authors: Li
authors: Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA.
authors: Ali
authors: A
authors: Hosseini
authors: Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA.
authors: Thomas J
authors: TJ
authors: Gill
authors: Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA.
authors: Guoan
authors: G
authors: Li
mesh_terms: D000328:Adult; D059549:Anterior Cruciate Ligament Reconstruction; D001696:Biomechanical Phenomena; D003198:Computer Simulation; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged
keywords: ACL; anatomical ACL reconstruction; double-bundle ACL reconstruction