title: Knee joint kinematics after dynamic intraligamentary stabilization: cadaveric study on a novel anterior cruciate ligament repair technique.
abstract: OBJECTIVE
  Dynamic intraligamentary stabilization (DIS) has been introduced for the repair of acute anterior cruciate ligament (ACL) tears as an alternative to delayed reconstruction. The aim of the present study was to compare knee joint kinematics after DIS to those of the ACL-intact and ACL-deficient knee under simulated Lachman/KT-1000 and pivot-shift tests. We hypothesized that DIS provides knee joint kinematics equivalent to an intact ACL.
  
  
  METHODS
  With the use of a robotic knee simulator, knee kinematics were determined in simulated Lachman/KT-1000 and pivot-shift tests at 0°, 15°, 30°, 60°, and 90° of flexion in eight cadaveric knees under the following conditions: (1) intact ACL, (2) ACL deficiency, (3) DIS with a preload of 60 N, and (4) DIS with a preload of 80 N. Statistical analyses were performed using two-factor repeated-measures analysis of variance. The significance level was set at a p value of <0.05.
  
  
  RESULTS
  After DIS with a preload of either 60 N or 80 N, the anterior translation was significantly reduced in the simulated Lachman/KT-1000 and pivot-shift tests when compared to the ACL-deficient knee (p < 0.05). No significant differences were observed between the DIS reconstruction with a preload of 80 N and the intact ACL with regard to anterior laxity in either test. However, DIS with a preload of only 60 N was not able to restore knee joint kinematics to that of an intact knee in all degrees of flexion.
  
  
  CONCLUSIONS
  DIS with a preload of 80 N restores knee joint kinematics comparable to that of an ACL-intact knee and is therefore capable of providing knee joint stability during ACL healing. DIS therefore provides a new technique for primary ACL repair with superior biomechanical properties in comparison with other techniques that have been described previously, although further clinical studies are required to determine its usefulness in clinical settings.
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Albert-Schweitzer-Campus, Building Waldeyerstraße 1, 48149, Münster, Germany. benedikt.schliemann@ukmuenster.de.
authors.forename: Benedikt
authors.initials: B
authors.lastname: Schliemann
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Albert-Schweitzer-Campus, Building Waldeyerstraße 1, 48149, Münster, Germany.
authors.forename: Simon
authors.initials: S
authors.lastname: Lenschow
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Albert-Schweitzer-Campus, Building Waldeyerstraße 1, 48149, Münster, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Domnick
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Albert-Schweitzer-Campus, Building Waldeyerstraße 1, 48149, Münster, Germany.
authors.forename: Mirco
authors.initials: M
authors.lastname: Herbort
authors.affiliation: Mathys Company, Bettlach, Switzerland.
authors.forename: Janosch
authors.initials: J
authors.lastname: Häberli
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Albert-Schweitzer-Campus, Building Waldeyerstraße 1, 48149, Münster, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Schulze
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Albert-Schweitzer-Campus, Building Waldeyerstraße 1, 48149, Münster, Germany.
authors.forename: Dirk
authors.initials: D
authors.lastname: Wähnert
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Albert-Schweitzer-Campus, Building Waldeyerstraße 1, 48149, Münster, Germany.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Raschke
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Albert-Schweitzer-Campus, Building Waldeyerstraße 1, 48149, Münster, Germany.
authors.forename: Clemens
authors.initials: C
authors.lastname: Kösters
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D001696:Biomechanical Phenomena / Q000502:physiology; D002102:Cadaver; D006801:Humans; D007593:Joint Instability / Q000503:physiopathology / Q000601:surgery; D007719:Knee Joint / Q000503:physiopathology* / Q000601:surgery; D008875:Middle Aged; D010808:Physical Examination / Q000379:methods
keywords: ACL instability; ACL reconstruction; ACL repair; Dynamic intraligamentary stabilization; Knee joint kinematics