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

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

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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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of Pittsburgh, 3471 Fifth Avenue, Suite 1011, Pittsburgh, PA, 15213, USA

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

  2. Department of Mechanical Engineering and Materials Science, University of Pittsburgh, Pittsburgh, PA, USA

    Patrick Smolinski & Freddie H. Fu

  3. Department of Orthopaedic Surgery, Chosun University Hospital, Gwang-ju, Korea

    Donghwi Kim

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  1. Donghwi Kim
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  2. Shigehiro Asai
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  9. Freddie H. Fu
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Correspondence to Freddie H. Fu.

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Kim, D., Asai, S., Moon, CW. et al. Biomechanical evaluation of anatomic single- and double-bundle anterior cruciate ligament reconstruction techniques using the quadriceps tendon. Knee Surg Sports Traumatol Arthrosc 23, 687–695 (2015). https://doi.org/10.1007/s00167-014-3462-y

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  • DOI: https://doi.org/10.1007/s00167-014-3462-y

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