Skip to main content
Top
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 12/2015

01-12-2015 | Knee

Rotational laxity after anatomical ACL reconstruction measured by 3-D motion analysis: a prospective randomized clinical trial comparing anatomic and nonanatomic ACL reconstruction techniques

Authors: Marie Bagger Bohn, Henrik Sørensen, Mette Krintel Petersen, Kjeld Søballe, Martin Lind

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 12/2015

Login to get access

Abstract

Purpose

To compare the ability of three different anterior cruciate ligament (ACL) reconstruction techniques to normalize rotational knee stability 1 year after ACL reconstruction. Two of these techniques are so-called anatomic techniques.

Methods

Three different ACL reconstruction techniques were tested for their ability to normalize rotational knee stability in a prospective randomized study. Forty-seven ACL-deficient (ACLD) patients were randomized to transtibial single-bundle (SB), anatomic SB, and double-bundle ACL reconstruction. Three-dimensional motion analysis was performed preoperatively and at 1-year follow-up to evaluate tibial rotation and rotational stiffness. Motion data were captured using an eight-camera motion analysis system. Tibial rotation was determined during walking, running, and a pivoting task. Other outcome parameters were KT-1000 knee laxity measurements and the subjective outcome scores KOOS and IKDC.

Results

Three-dimensional motion analysis demonstrated that the tibial internal rotation and the rotational stiffness did not differ between the ACL reconstruction techniques during walking, running, and pivoting at 1-year follow-up. Objective knee stability and subjective outcome scores did not differ between the reconstruction groups.

Conclusion

No significant difference in rotational stability walking, running, and pivoting was seen between anatomic and nonanatomic ACL reconstruction techniques at 1-year follow-up.

Level of evidence

Therapeutic study, Level I.
Literature
1.
go back to reference Aglietti P, Giron F, Losco M, Cuomo P, Ciardullo A, Mondanelli N (2010) Comparison between single-and double-bundle anterior cruciate ligament reconstruction: a prospective, randomized, single-blinded clinical trial. Am J Sports Med 38:25–34CrossRefPubMed Aglietti P, Giron F, Losco M, Cuomo P, Ciardullo A, Mondanelli N (2010) Comparison between single-and double-bundle anterior cruciate ligament reconstruction: a prospective, randomized, single-blinded clinical trial. Am J Sports Med 38:25–34CrossRefPubMed
2.
go back to reference Andriacchi TP, Dyrby CO (2005) Interactions between kinematics and loading during walking for the normal and ACL deficient knee. J Biomech 38:293–298CrossRefPubMed Andriacchi TP, Dyrby CO (2005) Interactions between kinematics and loading during walking for the normal and ACL deficient knee. J Biomech 38:293–298CrossRefPubMed
3.
go back to reference Branch TP, Browne JE, Campbell JD, Siebold R, Freedberg HI, Arendt EA, Lavoie F, Neyret P, Jacobs CA (2010) Rotational laxity greater in patients with contralateral anterior cruciate ligament injury than healthy volunteers. Knee Surg Sports Traumatol Arthrosc 18:1379–1384CrossRefPubMed Branch TP, Browne JE, Campbell JD, Siebold R, Freedberg HI, Arendt EA, Lavoie F, Neyret P, Jacobs CA (2010) Rotational laxity greater in patients with contralateral anterior cruciate ligament injury than healthy volunteers. Knee Surg Sports Traumatol Arthrosc 18:1379–1384CrossRefPubMed
4.
go back to reference Chouliaras V, Ristanis S, Moraiti C, Stergiou N, Georgoulis AD (2007) Effectiveness of reconstruction of the anterior cruciate ligament with quadrupled hamstrings and bone-patellar tendon-bone autografts: an in vivo study comparing tibial internal-external rotation. Am J Sports Med 35:189–196CrossRefPubMed Chouliaras V, Ristanis S, Moraiti C, Stergiou N, Georgoulis AD (2007) Effectiveness of reconstruction of the anterior cruciate ligament with quadrupled hamstrings and bone-patellar tendon-bone autografts: an in vivo study comparing tibial internal-external rotation. Am J Sports Med 35:189–196CrossRefPubMed
5.
go back to reference Chouliaras V, Ristanis S, Moraiti C, Tzimas V, Stergiou N, Georgoulis AD (2009) Anterior cruciate ligament reconstruction with a quadrupled hamstrings tendon autograft does not restore tibial rotation to normative levels during landing from a jump and subsequent pivoting. J Sports Med Phys Fit 49:64–70 Chouliaras V, Ristanis S, Moraiti C, Tzimas V, Stergiou N, Georgoulis AD (2009) Anterior cruciate ligament reconstruction with a quadrupled hamstrings tendon autograft does not restore tibial rotation to normative levels during landing from a jump and subsequent pivoting. J Sports Med Phys Fit 49:64–70
6.
go back to reference Claes S, Neven E, Callewaert B, Desloovere K, Bellemans J (2011) Tibial rotation in single- and double-bundle ACL reconstruction: a kinematic 3-D in vivo analysis. Knee Surg Sports Traumatol Arthrosc 19(Suppl 1):S115–S121CrossRefPubMed Claes S, Neven E, Callewaert B, Desloovere K, Bellemans J (2011) Tibial rotation in single- and double-bundle ACL reconstruction: a kinematic 3-D in vivo analysis. Knee Surg Sports Traumatol Arthrosc 19(Suppl 1):S115–S121CrossRefPubMed
7.
go back to reference Debandi A, Maeyama A, Hoshino Y, Asai S, Goto B, Smolinski P, Fu FH (2013) The effect of tunnel placement on rotational stability after ACL reconstruction: evaluation with use of triaxial accelerometry in a porcine model. Knee Surg Sports Traumatol Arthrosc 21:589–595CrossRefPubMed Debandi A, Maeyama A, Hoshino Y, Asai S, Goto B, Smolinski P, Fu FH (2013) The effect of tunnel placement on rotational stability after ACL reconstruction: evaluation with use of triaxial accelerometry in a porcine model. Knee Surg Sports Traumatol Arthrosc 21:589–595CrossRefPubMed
8.
go back to reference Frobell RB, Roos EM, Roos HP, Ranstam J, Lohmander LS (2010) A randomized trial of treatment for acute anterior cruciate ligament tears. N Engl J Med 363:331–342CrossRefPubMed Frobell RB, Roos EM, Roos HP, Ranstam J, Lohmander LS (2010) A randomized trial of treatment for acute anterior cruciate ligament tears. N Engl J Med 363:331–342CrossRefPubMed
9.
go back to reference Georgoulis AD, Ristanis S, Chouliaras V, Moraiti C, Stergiou N (2007) Tibial rotation is not restored after ACL reconstruction with a hamstring graft. Clin Orthop Relat Res 454:89–94CrossRefPubMed Georgoulis AD, Ristanis S, Chouliaras V, Moraiti C, Stergiou N (2007) Tibial rotation is not restored after ACL reconstruction with a hamstring graft. Clin Orthop Relat Res 454:89–94CrossRefPubMed
10.
go back to reference Grood ES, Suntay WJ (1983) A joint coordinate system for the clinical description of three-dimensional motions: application to the knee. J Biomech Eng 105:136–144CrossRefPubMed Grood ES, Suntay WJ (1983) A joint coordinate system for the clinical description of three-dimensional motions: application to the knee. J Biomech Eng 105:136–144CrossRefPubMed
11.
go back to reference Hemmerich A, van der Merwe W, Batterham M, Vaughan CL (2011) Knee rotational laxity in a randomized comparison of single- versus double-bundle anterior cruciate ligament reconstruction. Am J Sports Med 39:48–56CrossRefPubMed Hemmerich A, van der Merwe W, Batterham M, Vaughan CL (2011) Knee rotational laxity in a randomized comparison of single- versus double-bundle anterior cruciate ligament reconstruction. Am J Sports Med 39:48–56CrossRefPubMed
12.
go back to reference Jarvela T (2007) Double-bundle versus single-bundle anterior cruciate ligament reconstruction: a prospective, randomize clinical study. Knee Surg Sports Traumatol Arthrosc 15:500–507CrossRefPubMed Jarvela T (2007) Double-bundle versus single-bundle anterior cruciate ligament reconstruction: a prospective, randomize clinical study. Knee Surg Sports Traumatol Arthrosc 15:500–507CrossRefPubMed
13.
go back to reference Kocher MS, Steadman JR, Briggs KK, Sterett WI, Hawkins RJ (2004) Relationships between objective assessment of ligament stability and subjective assessment of symptoms and function after anterior cruciate ligament reconstruction. Am J Sports Med 32:629–634CrossRefPubMed Kocher MS, Steadman JR, Briggs KK, Sterett WI, Hawkins RJ (2004) Relationships between objective assessment of ligament stability and subjective assessment of symptoms and function after anterior cruciate ligament reconstruction. Am J Sports Med 32:629–634CrossRefPubMed
14.
go back to reference Lane CG, Warren R, Pearle AD (2008) The pivot shift. J Am Acad Orthop Surg 16:679–688PubMed Lane CG, Warren R, Pearle AD (2008) The pivot shift. J Am Acad Orthop Surg 16:679–688PubMed
15.
go back to reference Lee S, Kim H, Jang J, Seong SC, Lee MC (2012) Comparison of anterior and rotatory laxity using navigation between single- and double-bundle ACL reconstruction: prospective randomized trial. Knee Surg Sports Traumatol Arthrosc 20:752–761CrossRefPubMed Lee S, Kim H, Jang J, Seong SC, Lee MC (2012) Comparison of anterior and rotatory laxity using navigation between single- and double-bundle ACL reconstruction: prospective randomized trial. Knee Surg Sports Traumatol Arthrosc 20:752–761CrossRefPubMed
16.
go back to reference Lopomo N, Signorelli C, Bonanzinga T, Marcheggiani Muccioli GM, Visani A, Zaffagnini S (2012) Quantitative assessment of pivot-shift using inertial sensors. Knee Surg Sports Traumatol Arthrosc 20:713–717CrossRefPubMed Lopomo N, Signorelli C, Bonanzinga T, Marcheggiani Muccioli GM, Visani A, Zaffagnini S (2012) Quantitative assessment of pivot-shift using inertial sensors. Knee Surg Sports Traumatol Arthrosc 20:713–717CrossRefPubMed
17.
go back to reference Reinschmidt C, van den Bogert AJ, Nigg BM, Lundberg A, Murphy N (1997) Effect of skin movement on the analysis of skeletal knee joint motion during running. J Biomech 30:729–732CrossRefPubMed Reinschmidt C, van den Bogert AJ, Nigg BM, Lundberg A, Murphy N (1997) Effect of skin movement on the analysis of skeletal knee joint motion during running. J Biomech 30:729–732CrossRefPubMed
18.
go back to reference Ristanis S, Giakas G, Papageorgiou CD, Moraiti T, Stergiou N, Georgoulis AD (2003) The effects of anterior cruciate ligament reconstruction on tibial rotation during pivoting after descending stairs. Knee Surg Sports Traumatol Arthrosc 11:360–365CrossRefPubMed Ristanis S, Giakas G, Papageorgiou CD, Moraiti T, Stergiou N, Georgoulis AD (2003) The effects of anterior cruciate ligament reconstruction on tibial rotation during pivoting after descending stairs. Knee Surg Sports Traumatol Arthrosc 11:360–365CrossRefPubMed
19.
go back to reference Ristanis S, Stergiou N, Patras K, Tsepis E, Moraiti C, Georgoulis AD (2006) Follow-up evaluation 2 years after ACL reconstruction with bone-patellar tendon-bone graft shows that excessive tibial rotation persists. Clin J Sport Med 16:111–116CrossRefPubMed Ristanis S, Stergiou N, Patras K, Tsepis E, Moraiti C, Georgoulis AD (2006) Follow-up evaluation 2 years after ACL reconstruction with bone-patellar tendon-bone graft shows that excessive tibial rotation persists. Clin J Sport Med 16:111–116CrossRefPubMed
20.
go back to reference Ristanis S, Stergiou N, Patras K, Vasiliadis HS, Giakas G, Georgoulis AD (2005) Excessive tibial rotation during high-demand activities is not restored by anterior cruciate ligament reconstruction. Arthroscopy 21:1323–1329CrossRefPubMed Ristanis S, Stergiou N, Patras K, Vasiliadis HS, Giakas G, Georgoulis AD (2005) Excessive tibial rotation during high-demand activities is not restored by anterior cruciate ligament reconstruction. Arthroscopy 21:1323–1329CrossRefPubMed
21.
go back to reference Sakane M, Fox RJ, Woo SL, Livesay GA, Li G, Fu FH (1997) In situ forces in the anterior cruciate ligament and its bundles in response to anterior tibial loads. J Orthop Res 15:285–293CrossRefPubMed Sakane M, Fox RJ, Woo SL, Livesay GA, Li G, Fu FH (1997) In situ forces in the anterior cruciate ligament and its bundles in response to anterior tibial loads. J Orthop Res 15:285–293CrossRefPubMed
22.
go back to reference Siebold R (2011) The concept of complete footprint restoration with guidelines for single- and double-bundle ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 19:699–706CrossRefPubMed Siebold R (2011) The concept of complete footprint restoration with guidelines for single- and double-bundle ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 19:699–706CrossRefPubMed
23.
go back to reference Siebold R, Dehler C, Ellert T (2008) Prospective randomized comparison of double-bundle versus single-bundle anterior cruciate ligament reconstruction. Arthroscopy 24:137–145CrossRefPubMed Siebold R, Dehler C, Ellert T (2008) Prospective randomized comparison of double-bundle versus single-bundle anterior cruciate ligament reconstruction. Arthroscopy 24:137–145CrossRefPubMed
24.
go back to reference Tiamklang T, Sumanont S, Foocharoen T, Laopaiboon M (2012) Double-bundle versus single-bundle reconstruction for anterior cruciate ligament rupture in adults. Cochrane Database Syst Rev 11:CD008413PubMed Tiamklang T, Sumanont S, Foocharoen T, Laopaiboon M (2012) Double-bundle versus single-bundle reconstruction for anterior cruciate ligament rupture in adults. Cochrane Database Syst Rev 11:CD008413PubMed
25.
go back to reference Tsarouhas A, Iosifidis M, Kotzamitelos D, Spyropoulos G, Tsatalas T, Giakas G (2010) Three-dimensional kinematic and kinetic analysis of knee rotational stability after single- and double-bundle anterior cruciate ligament reconstruction. Arthroscopy 26:885–893CrossRefPubMed Tsarouhas A, Iosifidis M, Kotzamitelos D, Spyropoulos G, Tsatalas T, Giakas G (2010) Three-dimensional kinematic and kinetic analysis of knee rotational stability after single- and double-bundle anterior cruciate ligament reconstruction. Arthroscopy 26:885–893CrossRefPubMed
26.
go back to reference Tsarouhas A, Iosifidis M, Spyropoulos G, Kotzamitelos D, Tsatalas T, Giakas G (2011) Tibial rotation under combined in vivo loading after single- and double-bundle anterior cruciate ligament reconstruction. Arthroscopy 27:1654–1662CrossRefPubMed Tsarouhas A, Iosifidis M, Spyropoulos G, Kotzamitelos D, Tsatalas T, Giakas G (2011) Tibial rotation under combined in vivo loading after single- and double-bundle anterior cruciate ligament reconstruction. Arthroscopy 27:1654–1662CrossRefPubMed
27.
go back to reference van Eck CF, Kopf S, Irrgang JJ, Blankevoort L, Bhandari M, Fu FH, Poolman RW (2012) Single-bundle versus double-bundle reconstruction for anterior cruciate ligament rupture: a meta-analysis–does anatomy matter? Arthroscopy 28:405–424CrossRefPubMed van Eck CF, Kopf S, Irrgang JJ, Blankevoort L, Bhandari M, Fu FH, Poolman RW (2012) Single-bundle versus double-bundle reconstruction for anterior cruciate ligament rupture: a meta-analysis–does anatomy matter? Arthroscopy 28:405–424CrossRefPubMed
28.
go back to reference Wang H, Fleischli JE, Zheng NN (2013) Transtibial versus anteromedial portal technique in single-bundle anterior cruciate ligament reconstruction: outcomes of knee joint kinematics during walking. Am J Sports Med 41:1847–1856CrossRefPubMed Wang H, Fleischli JE, Zheng NN (2013) Transtibial versus anteromedial portal technique in single-bundle anterior cruciate ligament reconstruction: outcomes of knee joint kinematics during walking. Am J Sports Med 41:1847–1856CrossRefPubMed
29.
go back to reference Yagi M, Wong EK, Kanamori A, Debski RE, Fu FH, Woo SL (2002) Biomechanical analysis of an anatomic anterior cruciate ligament reconstruction. Am J Sports Med 30:660–666PubMed Yagi M, Wong EK, Kanamori A, Debski RE, Fu FH, Woo SL (2002) Biomechanical analysis of an anatomic anterior cruciate ligament reconstruction. Am J Sports Med 30:660–666PubMed
30.
go back to reference Yasuda K, Tanabe Y, Kondo E, Kitamura N, Tohyama H (2010) Anatomic double-bundle anterior cruciate ligament reconstruction. Arthroscopy 26:S21–S34CrossRefPubMed Yasuda K, Tanabe Y, Kondo E, Kitamura N, Tohyama H (2010) Anatomic double-bundle anterior cruciate ligament reconstruction. Arthroscopy 26:S21–S34CrossRefPubMed
31.
go back to reference Zaffagnini S, Marcheggiani Muccioli GM, Signorelli C, Lopomo N, Grassi A, Bonanzinga T, Nitri M, Marcacci M (2014) Anatomic and nonanatomic double-bundle anterior cruciate ligament reconstruction: an in vivo kinematic analysis. Am J Sports Med 42:708–715CrossRefPubMed Zaffagnini S, Marcheggiani Muccioli GM, Signorelli C, Lopomo N, Grassi A, Bonanzinga T, Nitri M, Marcacci M (2014) Anatomic and nonanatomic double-bundle anterior cruciate ligament reconstruction: an in vivo kinematic analysis. Am J Sports Med 42:708–715CrossRefPubMed
32.
go back to reference Zhu Y, Tang RK, Zhao P, Zhu SS, Li YG, Li JB (2013) Double-bundle reconstruction results in superior clinical outcome than single-bundle reconstruction. Knee Surg Sports Traumatol Arthrosc 21:1085–1096CrossRefPubMed Zhu Y, Tang RK, Zhao P, Zhu SS, Li YG, Li JB (2013) Double-bundle reconstruction results in superior clinical outcome than single-bundle reconstruction. Knee Surg Sports Traumatol Arthrosc 21:1085–1096CrossRefPubMed
Metadata
Title
Rotational laxity after anatomical ACL reconstruction measured by 3-D motion analysis: a prospective randomized clinical trial comparing anatomic and nonanatomic ACL reconstruction techniques
Authors
Marie Bagger Bohn
Henrik Sørensen
Mette Krintel Petersen
Kjeld Søballe
Martin Lind
Publication date
01-12-2015
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 12/2015
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-014-3156-5

Other articles of this Issue 12/2015

Knee Surgery, Sports Traumatology, Arthroscopy 12/2015 Go to the issue