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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 8/2017

01-08-2017 | Knee

Double-bundle posterior cruciate ligament reconstruction: a biomechanical analysis of simulated early motion and partial and full weightbearing on common reconstruction grafts

Authors: William R. Mook, David Civitarese, Travis Lee Turnbull, Nicholas I. Kennedy, Luke O’Brien, Jarod B. Schoeberl, Robert F. LaPrade

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 8/2017

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Abstract

Purpose

The purpose of this study was to determine the biomechanical effects of simulated immediate motion and weightbearing during rehabilitation on different double-bundle posterior cruciate ligament reconstruction (DB-PCLR) graft options.

Methods

Nine each of commercially prepared (allograft) Achilles tendon allografts, fresh-frozen (autograft) bone-patellar tendon-bone grafts, and fresh-frozen quadriceps tendon grafts were paired with commercially prepared anterior tibialis allografts, fresh-frozen semitendinosus grafts, and fresh-frozen semitendinosus grafts, respectively. Graft pairs were loaded to simulate early range of motion on a stationary bicycle, partial weightbearing (30 %), and full weightbearing.

Results

Acquired laxity (displacement, mm) between graft pairs was not significantly different during simulated early range of motion. However, during simulated partial weightbearing, the median acquired laxity of the patellar tendon/semitendinosus pair (1.06 mm) was significantly less than that of the quadriceps tendon/semitendinosus (1.50 mm, p = 0.01) and Achilles/anterior tibialis (1.44 mm, p = 0.003) graft pairs. During simulated full weightbearing, significantly less acquired laxity was observed for the patellar tendon/semitendinosus graft pair (2.38 mm) compared to the Achilles/anterior tibialis pair (4.85 mm, p = 0.04), but a significant difference was not observed compared to the QT/semitendinosus graft pair (3.91 mm, n.s.). There were no significant differences in the ultimate loads between any of the graft pairs.

Conclusions

Simulated early range of motion and early partial weightbearing did not result in clinically significant acquired graft laxity in common graft options utilized for DB-PCLR. However, simulated full weightbearing did result in clinically significant acquired graft laxity, and therefore, early rehabilitation protocols should avoid implementing full weightbearing that could contribute to graft failure.
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Metadata
Title
Double-bundle posterior cruciate ligament reconstruction: a biomechanical analysis of simulated early motion and partial and full weightbearing on common reconstruction grafts
Authors
William R. Mook
David Civitarese
Travis Lee Turnbull
Nicholas I. Kennedy
Luke O’Brien
Jarod B. Schoeberl
Robert F. LaPrade
Publication date
01-08-2017
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 8/2017
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-016-4056-7

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