title: Anterior cruciate ligament reconstruction and cartilage contact forces--A 3D computational simulation.
abstract: BACKGROUND
  Clinical outcome studies showed a high incidence of knee osteoarthritis after anterior cruciate ligament reconstruction. Abnormal joint kinematics and loading conditions were assumed as risking factors. However, little is known on cartilage contact forces after the surgery.
  
  
  METHODS
  A validated computational model was used to simulate anatomic and transtibial single-bundle anterior cruciate ligament reconstructions. Two graft fixation angles (0° and 30°) were simulated for each reconstruction. Biomechanics of the knee was investigated in intact, anterior cruciate ligament deficient and reconstructed conditions when the knee was subjected to 134 N anterior load and 400 N quadriceps load at 0°, 30°, 60° and 90° of flexion. The tibial translation and rotation, graft forces, medial and lateral contact forces were calculated.
  
  
  RESULTS
  When the graft was fixed at 0°, the anatomic reconstruction resulted in slightly larger lateral contact force at 0° compared to the intact knee while the transtibial technique led to higher contact force at both 0° and 30° under the muscle load. When graft was fixed at 30°, the anatomic reconstruction overstrained the knee at 0° with larger contact forces, while the transtibial technique resulted in slightly larger contact forces at 30°.
  
  
  CONCLUSIONS
  This study suggests that neither the anatomic nor the transtibial reconstruction can consistently restore normal knee biomechanics at different flexion angles. The anatomic reconstruction may better restore anteroposterior stability and contact force with the graft fixed at 0°. The transtibial technique may better restore knee anteroposterior stability and articular contact force with the graft fixed at 30° of flexion.
authors: Bioengineering Laboratory, Department of Orthopedic Surgery, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA; Department of Orthopedic Surgery, China-Japan Union Hospital of Jilin University, Changchun, Jilin Province, PR China.
authors: Lianxin
authors: L
authors: Wang
authors: Bioengineering Laboratory, Department of Orthopedic Surgery, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA; Institute of Sports Medicine, Peking University Third Hospital, North Garden Road, Haidian District, Beijing 100191, PR China.
authors: Lin
authors: L
authors: Lin
authors: Bioengineering Laboratory, Department of Orthopedic Surgery, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA; Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, PR China.
authors: Yong
authors: Y
authors: Feng
authors: Bioengineering Laboratory, Department of Orthopedic Surgery, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA; Institute of Orthopedics and Traumatology, Hospital Das Clínicas, School of Medicine, University of São Paulo, 333 Dr. Ovídio Pires de Campos, 05403-010 São Paulo, Brazil.
authors: Tiago Lazzaretti
authors: TL
authors: Fernandes
authors: Bioengineering Laboratory, Department of Orthopedic Surgery, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA.
authors: Peter
authors: P
authors: Asnis
authors: Bioengineering Laboratory, Department of Orthopedic Surgery, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA.
authors: Ali
authors: A
authors: Hosseini
authors: Bioengineering Laboratory, Department of Orthopedic Surgery, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA. Electronic address: Li.Guoan@mgh.harvard.edu.
authors: Guoan
authors: G
authors: Li
mesh_terms: D016118:Anterior Cruciate Ligament / Q000503:physiopathology* / Q000601:surgery; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D001696:Biomechanical Phenomena; D002356:Cartilage / Q000502:physiology*; D003198:Computer Simulation; D006801:Humans; D007593:Joint Instability / Q000503:physiopathology*; D007718:Knee Injuries / Q000601:surgery; D007719:Knee Joint / Q000502:physiology*; D020370:Osteoarthritis, Knee / Q000209:etiology / Q000503:physiopathology; D011183:Postoperative Complications / Q000503:physiopathology*; D016059:Range of Motion, Articular; D012399:Rotation; D013977:Tibia / Q000502:physiology; D016474:Weight-Bearing / Q000502:physiology
keywords: Anterior cruciate ligament reconstruction; Biomechanics; Computational model; Contact force