title: Kinematics of ACL and anterolateral ligament. Part II: anterolateral and anterior cruciate ligament reconstruction.
abstract: OBJECTIVE
  To quantify the influence of Single-Bundle with Lateral Plasty and Double-Bundle reconstruction on static and dynamic laxity in combined ACL- and ALL-deficient knees.
  
  
  METHODS
  The study included 10 fresh-frozen human knees. The joints were analyzed in the following conditions: ACL + ALL resection, Single-Bundle with Lateral Plasty (SBLP) reconstruction, Double-Bundle (DB) reconstruction. Testing parameters were: anterior displacement at 30° and 90° of flexion (AP30, AP90) applying a manual maximum load; internal rotation at 30° and 90° of flexion (INT30, INT90) applying a 5 Nm torque and acceleration and internal rotation Pivot-Shift (PS) test. Kinematics was acquired by a navigation system. Paired Student's t test was conducted to assess statistical difference (P < 0.05).
  
  
  RESULTS
  At both 30° and 90° of knee flexion, both SBLP and DB surgical techniques showed a significant reduction (P < 0.01) of anterior-posterior tibial displacement compared to the resection of ACL + ALL. At 30° on knee flexion it is the SBLP that allows the greatest reduction of internal rotational laxity when compared to DB reconstruction. Concerning the PS test, only SBPL procedure had a significant laxity decrease considering the acceleration reached by the joint when compared with the ACL + ALL state (P < 0.01).
  
  
  CONCLUSIONS
  Clinical relevance of this study is that the internal rotation and PS test were more efficiently controlled by the SBLP technique than by the DB one at both 30° and 90° of flexion in case of ACL + ALL lesions.
authors.affiliation: Humanitas Clinical and Research Center, Milano, MI, Italy.|Dipartimento Scienze Biomediche e Neuromotorie, Università di Bologna, DIBINEM, Bologna, BO, Italy.
authors.forename: T
authors.initials: T
authors.lastname: Bonanzinga
authors.affiliation: Istituto Ortopedico Rizzoli, Laboratorio di Biomeccanica e Innovazione Tecnologica, Via Di Barbiano 1/10, Bologna, BO, Italy. c.signorelli@biomec.ior.it.
authors.forename: C
authors.identifier: http://orcid.org/0000-0001-7790-9413
authors.initials: C
authors.lastname: Signorelli
authors.affiliation: Istituto Ortopedico Rizzoli, Laboratorio di Biomeccanica e Innovazione Tecnologica, Via Di Barbiano 1/10, Bologna, BO, Italy.|Istituto Ortopedico Rizzoli, Clinica Ortopedica e Traumatologica I, Bologna, BO, Italy.|Dipartimento Rizzoli Sicilia, Istituto Ortopedico Rizzoli, Bagheria, PA, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Grassi
authors.affiliation: Istituto Ortopedico Rizzoli, Laboratorio di Biomeccanica e Innovazione Tecnologica, Via Di Barbiano 1/10, Bologna, BO, Italy.|Dipartimento di Ingegneria dell'Informazione, Università degli Studi di Brescia, Brescia, BS, Italy.
authors.forename: N
authors.initials: N
authors.lastname: Lopomo
authors.affiliation: Mohit Hospital, Borivali East, Mumbai, India.
authors.forename: M
authors.initials: M
authors.lastname: Jain
authors.affiliation: Istituto Ortopedico Rizzoli, Clinica Ortopedica e Traumatologica I, Bologna, BO, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Mosca
authors.affiliation: Istituto Ortopedico Rizzoli, Laboratorio di Biomeccanica e Innovazione Tecnologica, Via Di Barbiano 1/10, Bologna, BO, Italy.|Istituto Ortopedico Rizzoli, Clinica Ortopedica e Traumatologica I, Bologna, BO, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Iacono
authors.affiliation: Dipartimento Scienze Biomediche e Neuromotorie, Università di Bologna, DIBINEM, Bologna, BO, Italy.|Istituto Ortopedico Rizzoli, Laboratorio di Biomeccanica e Innovazione Tecnologica, Via Di Barbiano 1/10, Bologna, BO, Italy.|Istituto Ortopedico Rizzoli, Clinica Ortopedica e Traumatologica I, Bologna, BO, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Marcacci
authors.affiliation: Dipartimento Scienze Biomediche e Neuromotorie, Università di Bologna, DIBINEM, Bologna, BO, Italy.|Istituto Ortopedico Rizzoli, Laboratorio di Biomeccanica e Innovazione Tecnologica, Via Di Barbiano 1/10, Bologna, BO, Italy.|Istituto Ortopedico Rizzoli, Clinica Ortopedica e Traumatologica I, Bologna, BO, Italy.|Dipartimento Rizzoli Sicilia, Istituto Ortopedico Rizzoli, Bagheria, PA, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Zaffagnini
mesh_terms: D000368:Aged; D016118:Anterior Cruciate Ligament / Q000502:physiology / Q000601:surgery*; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D001696:Biomechanical Phenomena; D002102:Cadaver; D006801:Humans; D007593:Joint Instability / Q000503:physiopathology / Q000601:surgery*; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery*; D008023:Ligaments, Articular / Q000502:physiology / Q000601:surgery*; D016059:Range of Motion, Articular / Q000502:physiology; D012399:Rotation; D013709:Tendon Transfer / Q000379:methods
keywords: Anterolateral; Combined lesions; Laxity; Navigation system; Reconstruction