Repository logo
  • Log In
    Log in via Symplectic to deposit your publication(s).
Repository logo
  • Communities & Collections
  • Research Outputs
  • Statistics
  • Log In
    Log in via Symplectic to deposit your publication(s).
  1. Home
  2. Faculty of Engineering
  3. Faculty of Engineering
  4. Biomechanical comparison of graft structures in anterior cruciate ligament reconstruction
 
  • Details
Biomechanical comparison of graft structures in anterior cruciate ligament reconstruction
File(s)
art%3A10.1007%2Fs00167-016-4316-6.pdf (3.11 MB)
Published version
Author(s)
Lord, BR
El-Daou, H
Sabnis, BM
Gupte, CM
Wilson, AM
more
Type
Journal Article
Abstract
PURPOSE: Double-bundle (DB) anterior cruciate ligament (ACL) reconstruction may offer kinematic restoration superior to anatomic single bundle (SB), but it remains technically challenging. The femoral attachment site has the most effect on ACL graft isometry, so a simplified three-socket (3S) construct which still uses two sockets to cover the femoral ACL attachment is attractive. It was hypothesised that ACL reconstruction using three- and four-socket techniques would more closely restore native knee kinematics compared to anatomic two-socket (SB) surgery. METHODS: Nine cadaveric knees were used to evaluate the kinematics of ACL-intact, ACL-deficient, anatomic SB, three-socket, and DB arthroscopic ACL reconstructions. Suspensory fixation was used, and grafts were tensioned to match the anterior draw of the intact knee at 20°. A six-degree-of-freedom robotic system measured knee laxity under 90 N anterior tibial force and rotational laxity under 5 N-m torque. Combined moments were applied to simulate the pivot-shift subluxation: 4 N-m internal rotation and 8 N-m valgus. RESULTS: Significant differences between reconstructions were not found during anterior tibial loading, apart from SB being more lax than DB at 60° flexion. All reconstructions produced comparable laxity to the intact state, apart from SB at 60°. Significant differences between reconstructions were not found at any flexion angle during tibial internal/external applied torques. Under combined loading, DB produced significantly less laxity than SB constructs apart from anterior tibial translation at 0° and internal rotation at 45°. 3S and DB were comparable to the native knee throughout. CONCLUSION: Although 3S restored laxities to a similar extent to DB, significant superiority over SB surgery was not observed. Although statistically significant differences were found between SB and DB surgery during anterior tibial and simulated pivot-shift loading, both remained similar to the native knee. The clinical relevance is that this study did not support an ACL graft construct more complex than an anatomic single bundle.
Date Issued
2016-09-16
Date Acceptance
2016-09-01
Citation
Knee Surgery Sports Traumatology Arthroscopy, 2016, 25 (2), pp.559-568
URI
http://hdl.handle.net/10044/1/40798
DOI
https://www.dx.doi.org/10.1007/s00167-016-4316-6
ISSN
1433-7347
Publisher
Springer Verlag (Germany)
Start Page
559
End Page
568
Journal / Book Title
Knee Surgery Sports Traumatology Arthroscopy
Volume
25
Issue
2
Copyright Statement
© The Author(s) 2016. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
License URL
http://creativecommons.org/licenses/by/4.0/
Sponsor
Engineering & Physical Science Research Council (EPSRC)
Wellcome Trust
Identifier
PII: 10.1007/s00167-016-4316-6
Grant Number
N/A
088844/Z/09/Z
Subjects
Anatomic ACL reconstruction
Anterior cruciate ligament
Double bundle
Knee kinematics
Pivot shift
Robotics
Single bundle
TriLink
Publication Status
Published
About
Spiral Depositing with Spiral Publishing with Spiral Symplectic
Contact us
Open access team Report an issue
Other Services
Scholarly Communications Library Services
logo

Imperial College London

South Kensington Campus

London SW7 2AZ, UK

tel: +44 (0)20 7589 5111

Accessibility Modern slavery statement Cookie Policy

Built with DSpace-CRIS software - Extension maintained and optimized by 4Science

  • Cookie settings
  • Privacy policy
  • End User Agreement
  • Send Feedback