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Knee Surgery, Sports Traumatology, Arthroscopy

Published in:

01-03-2015 | Knee

Biomechanical evaluation of anatomic single- and double-bundle anterior cruciate ligament reconstruction techniques using the quadriceps tendon

Authors: Donghwi Kim, Shigehiro Asai, Chan-Woong Moon, Sun-Chul Hwang, Sahnghoon Lee, Kenan Keklikci, Monica Linde-Rosen, Patrick Smolinski, Freddie H. Fu

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 3/2015

Abstract

Purpose

Quadriceps tendon grafts have renewed interest for ACL reconstruction; however, biomechanical studies comparing anatomic single-bundle (SB) and double-bundle (DB) reconstruction techniques are rare. The purpose of this study was to compare the knee biomechanics in four different types of anatomic ACL reconstruction techniques, using the quadriceps tendon in a human cadaver.

Methods

Four different tibial (T) and femoral (F) tunnel configurations, (a) DB-2F-2T, (b) DB-2F-1T, (c) SB-1F-1T and (d) DB-1F-2T, were used for ACL reconstruction using the split quadriceps tendon with patella bone. Ten cadaver knees were subjected to an 89 N anterior tibial load and combined 7 N m valgus and 5 N m internal torques. The anterior tibial translation (ATT) and in situ force were measured using a robotic system for the ACL-intact, ACL-deficient and ACL-reconstructed knees.

Results

DB reconstructions mostly restored ATT to the intact ACL. The in situ forces under the anterior load in the DB reconstructions were similar to the intact ACL, but that of the SB reconstruction was different at 30°, 60° and 90° of flexion (P < 0.05). Under combined torques, the in situ force of the SB graft was less than that of intact ACL at 0°, 15° and 30° of knee flexion (P < 0.05), while that of the ACL DB reconstruction was similar to the intact ACL.

Conclusion

DB ACL reconstruction using quadriceps tendon can restore biomechanics of the knee to that of the intact ACL regardless of whether three or four tunnels are used, but SB reconstruction does not.

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Title: Biomechanical evaluation of anatomic single- and double-bundle anterior cruciate ligament reconstruction techniques using the quadriceps tendon
Authors: Donghwi Kim
Shigehiro Asai
Chan-Woong Moon
Sun-Chul Hwang
Sahnghoon Lee
Kenan Keklikci
Monica Linde-Rosen
Patrick Smolinski
Freddie H. Fu
Publication date: 01-03-2015
Publisher: Springer Berlin Heidelberg
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 3/2015
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-014-3462-y

At a glance: The STEP trials

Springer Medicine

Biomechanical evaluation of anatomic single- and double-bundle anterior cruciate ligament reconstruction techniques using the quadriceps tendon

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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