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Knee Surgery, Sports Traumatology, Arthroscopy

Published in:

01-10-2018 | Knee

Coronal tibial anteromedial tunnel location has minimal effect on knee biomechanics

Authors: Shigehiro Asai, Donghwi Kim, Yuichi Hoshino, Chan-Woong Moon, Akira Maeyama, Monica Linde, Patrick Smolinski, Freddie H. Fu

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 10/2018

Abstract

Purpose

Studies have found anatomic variation in the coronal position of the insertion site of anteromedial (AM) bundle of the anterior cruciate ligament (ACL) on the tibia, which can lead to questions about tunnel placement during ACL reconstruction. The purpose of this study was to determine how mediolateral placement of the tibial AM graft tunnel in double-bundle ACL reconstructions affects knee biomechanics.

Methods

Two different types of double-bundle ACL reconstructions were performed. The AM tibial tunnel was placed at either the medial or lateral portion of tibial AM footprint. Nine cadaveric knees were tested with the robotic/universal force-moment sensor system with the use of (1) an 89.0-N anterior tibial load at full extension (FE), 30°, 60° and 90° of knee flexion and (2) a combined 7.0-Nm valgus torque and 5.0-Nm internal tibial rotation torque at FE, 15°, 30°and 45° of knee flexion.

Results

Both medial (2.6 ± 1.2 mm) and lateral (1.6 ± 0.9 mm) double-bundle reconstructions reduced the anterior tibial translation (ATT) to less than the intact value (3.9 ± 0.7 mm) at FE. At all other flexion angles, there was no significant different in ATT between the intact knee and the reconstructions. At FE, the ATT for the medial AM reconstruction was different from that of the lateral AM construction and closer to the intact ACL value.

Conclusion

The coronal tibial placement of the AM tunnel had only a slight effect on knee biomechanics. In patients with differing AM bundle coronal positions, the AM tibial tunnel can be placed anatomically at the native insertion site.

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Title: Coronal tibial anteromedial tunnel location has minimal effect on knee biomechanics
Authors: Shigehiro Asai
Donghwi Kim
Yuichi Hoshino
Chan-Woong Moon
Akira Maeyama
Monica Linde
Patrick Smolinski
Freddie H. Fu
Publication date: 01-10-2018
Publisher: Springer Berlin Heidelberg
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 10/2018
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-018-4844-3

At a glance: The STEP trials

Springer Medicine

Coronal tibial anteromedial tunnel location has minimal effect on knee biomechanics

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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