Top

Knee Surgery, Sports Traumatology, Arthroscopy

Published in:

01-12-2011 | Knee

Tibial rotation in single- and double-bundle ACL reconstruction: a kinematic 3-D in vivo analysis

Authors: Steven Claes, Enrico Neven, Barbara Callewaert, Kaat Desloovere, Johan Bellemans

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Special Issue 1/2011

Abstract

Purpose

The effect of double-bundle ACL reconstruction on knee kinematics has recently been studied by several authors under controlled laboratory conditions however little evidence has been derived from dynamic in vivo evaluations. This study hypothesized that tibial rotation during pivoting motor tasks would be better restored after double-bundle ACL reconstructions when compared with single-bundle procedures.

Methods

Twenty patients with a chronic ACL rupture were randomly assigned to receive a single- or double-bundle ACL reconstruction. Both knees were evaluated pre-operatively by kinematic 3-D gait analysis while performing low- and high-demand motor tasks, including pivoting. At 6 months post-operatively, measurements were repeated in 16 patients. Ten healthy, sex- and age-matched subjects with no history of lower limb pathology formed the control group. The tibial rotational excursion was set as the dependent variable.

Results

The results indicate that at 6 months after surgery both “anatomic” single- and double-bundle ACL reconstruction are able to restore tibial rotational excursion when compared with the contralateral knees and with control knees from uninjured subjects. Chronic ACL-deficient patients show an increase in tibial rotation in both knees during high-demand pivoting tasks.

Conclusions

Both “anatomic” single- and double-bundle ACL reconstruction adequately restore tibial rotational excursion in a human, “in vivo” kinematic model. As knee stability measurements by in vivo kinematic 3-D analysis more accurately represent actual knee loading during activities, the results of this study might better correlate with functional outcome after ACL reconstructions compared with static knee stability tests or ex vivo laboratory experiments. In such, the results of this dynamic study do not support the theoretical advantage of a double-bundle ACL reconstruction over an “anatomic” single-bundle ACL reconstruction.

Level of evidence

II.

Barber SD, Noyes FR, Mangine RE, McCloskey JW, Hartman W (1990) Quantitative assessment of functional limitations in normal and anterior cruciate ligament-deficient knees. Clin Orthop Relat Res 255:204–214PubMed

Bellemans J, Eid T, Fabry G (1999) A modified technique for tibial interference screw fixation of hamstring anterior cruciate ligament grafts. Arthroscopy 15:669–671PubMedCrossRef

Branch TP, Siebold R, Freedberg HI, Jacobs CA (2011) Double-bundle ACL reconstruction demonstrated superior clinical stability to single-bundle ACL reconstruction: a matched-pairs analysis of instrumented tests of tibial anterior translation and internal rotation laxity. Knee Surg Sports Traumatol Arthrosc 19:432–440PubMedCrossRef

Desloovere K, Wong P, Swings L, Callewaert B, Vandenneucker H, Leardini A (2010) Range of motion and repeatability of knee kinematics for 11 clinically relevant motor tasks. Gait Posture 32:597–602PubMedCrossRef

Ferber R, McClay Davis I, Williams DS 3rd, Laughton C (2002) A comparison of within- and between-day reliability of discrete 3D lower extremity variables in runners. J Orthop Res 20:1139–1145PubMedCrossRef

Ferretti A, Monaco E, Labianca L, De Carli A, Maestri B, Conteduca F (2009) Double-bundle anterior cruciate ligament reconstruction: a comprehensive kinematic study using navigation. Am J Sports Med 37:1548–1553PubMedCrossRef

Georgoulis AD, Papadonikolakis A, Papageorgiou CD, Mitsou A, Stergiou N (2003) Three-dimensional tibiofemoral kinematics of the anterior cruciate ligament-deficient and reconstructed knee during walking. Am J Sports Med 31:75–79PubMed

Grood ES, Suntay WJ (1983) A joint coordinate system for the clinical description of three-dimensional motions: application to the knee. J Biomech Eng 105:136–144PubMedCrossRef

Ho JY, Gardiner A, Shah V, Steiner ME (2009) Equal kinematics between central anatomic single-bundle and double-bundle anterior cruciate ligament reconstructions. Arthroscopy 25:464–472PubMedCrossRef

10.

Lindstrom M, Fellander-Tsai L, Wredmark T, Henriksson M (2010) Adaptations of gait and muscle activation in chronic ACL deficiency. Knee Surg Sports Traumatol Arthrosc 18:106–114PubMedCrossRef

11.

Misonoo G, Kanamori A, Ida H, Miyakawa S, Ochiai N (2011) Evaluation of tibial rotational stability of single-bundle vs. anatomical double-bundle anterior cruciate ligament reconstruction during a high-demand activity—A quasi-randomized trial. Knee. Epub ahead of print. doi:10.1016/j.knee.2011.01.003

12.

Motohashi M (2004) Profile of bilateral anterior cruciate ligament injuries: a retrospective follow-up study. J Orthop Surg (Hong Kong) 12:210–215

13.

Müller W (1983) The knee: form, function and ligament reconstruction. The knee: form, function and ligament reconstruction. Springer-Verlag, Berlin

14.

Park SJ, Jung YB, Jung HJ, Shin HK, Kim E, Song KS, Kim GS, Cheon HY, Kim S (2010) Outcome of arthroscopic single-bundle versus double-bundle reconstruction of the anterior cruciate ligament: a preliminary 2-year prospective study. Arthroscopy 26:630–636PubMedCrossRef

15.

Pinczewski LA, Lyman J, Salmon LJ, Russell VJ, Roe J, Linklater J (2007) A 10-year comparison of anterior cruciate ligament reconstructions with hamstring tendon and patellar tendon autograft: a controlled, prospective trial. Am J Sports Med 35:564–574PubMedCrossRef

16.

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 11:360–365PubMedCrossRef

17.

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 21:1323–1329PubMedCrossRef

18.

Ristanis S, Stergiou N, Siarava E, Ntoulia A, Mitsionis G, Georgoulis AD (2009) Effect of femoral tunnel placement for reconstruction of the anterior cruciate ligament on tibial rotation. J Bone Joint Surg Am 91:2151–2158PubMedCrossRef

19.

Seon JK, Song EK, Park SJ (2006) Osteoarthritis after anterior cruciate ligament reconstruction using a patellar tendon autograft. Int Orthop 30:94–98PubMedCrossRef

20.

Shelbourne KD, Davis TJ, Klootwyk TE (1998) The relationship between intercondylar notch width of the femur and the incidence of anterior cruciate ligament tears. A prospective study. Am J Sports Med 26:402–408PubMed

21.

Shen W, Forsythe B, Ingham SM, Honkamp NJ, Fu FH (2008) Application of the anatomic double-bundle reconstruction concept to revision and augmentation anterior cruciate ligament surgeries. J Bone Joint Surg Am 90(Suppl 4):20–34PubMedCrossRef

22.

Song EK, Oh LS, Gill TJ, Li G, Gadikota HR, Seon JK (2009) Prospective comparative study of anterior cruciate ligament reconstruction using the double-bundle and single-bundle techniques. Am J Sports Med 37(9):1705–1711PubMedCrossRef

23.

Stergiou N, Ristanis S, Moraiti C, Georgoulis AD (2007) Tibial rotation in anterior cruciate ligament (ACL)-deficient and ACL-reconstructed knees: a theoretical proposition for the development of osteoarthritis. Sports Med 37:601–613PubMedCrossRef

24.

Sward P, Kostogiannis I, Roos H (2010) Risk factors for a contralateral anterior cruciate ligament injury. Knee Surg Sports Traumatol Arthrosc 18:277–291PubMedCrossRef

25.

Takeda Y, Sato R, Ogawa T, Fujii K, Naruse A (2009) In vivo magnetic resonance imaging measurement of tibiofemoral relation with different knee flexion angles after single- and double-bundle anterior cruciate ligament reconstructions. Arthroscopy 25:733–741PubMedCrossRef

26.

Tashman S, Collon D, Anderson K, Kolowich P, Anderst W (2004) Abnormal rotational knee motion during running after anterior cruciate ligament reconstruction. Am J Sports Med 32:975–983PubMedCrossRef

27.

Tashman S, Kopf S, Fu FH (2008) The Kinematic Basis of ACL Reconstruction. Oper Tech Sports Med 16:116–118PubMedCrossRef

28.

Tegner Y, Lysholm J (1985) Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res 198:43–49PubMed

29.

Teixeira da Fonseca S, Silva PL, Ocarino JM, Guimaraes RB, Oliveira MT, Lage CA (2004) Analyses of dynamic co-contraction level in individuals with anterior cruciate ligament injury. J Electromyogr Kinesiol 14(2):239–247PubMedCrossRef

30.

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 26:885–893PubMedCrossRef

31.

van Eck CF, Schreiber VM, Liu TT, Fu FH (2010) The anatomic approach to primary, revision and augmentation anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 18:1154–1163PubMedCrossRef

32.

Webster KE, McClelland JA, Wittwer JE, Tecklenburg K, Feller JA (2010) Three dimensional motion analysis of within and between day repeatability of tibial rotation during pivoting. Knee 17:329–333PubMedCrossRef

33.

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

34.

Yoo YS, Jeong WS, Shetty NS, Ingham SJ, Smolinski P, Fu F (2010) Changes in ACL length at different knee flexion angles: an in vivo biomechanical study. Knee Surg Sports Traumatol Arthrosc 18:292–297PubMedCrossRef

Title: Tibial rotation in single- and double-bundle ACL reconstruction: a kinematic 3-D in vivo analysis
Authors: Steven Claes
Enrico Neven
Barbara Callewaert
Kaat Desloovere
Johan Bellemans
Publication date: 01-12-2011
Publisher: Springer-Verlag
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue Special Issue 1/2011
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-011-1568-z

At a glance: The STEP trials

Springer Medicine

Tibial rotation in single- and double-bundle ACL reconstruction: a kinematic 3-D in vivo analysis

Abstract

Purpose

Methods

Results

Conclusions

Level of evidence

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Level of evidence

Please log in to get access to this content

Other articles of this Special Issue 1/2011

The superficial medial collateral ligament reconstruction of the knee: effect of altering graft length on knee kinematics and stability

MRI analysis of the attachment of the anteromedial and posterolateral bundles of anterior cruciate ligament using coronal oblique images

Full knee extension magnetic resonance imaging for the evaluation of intercondylar roof impingement after anatomical double-bundle anterior cruciate ligament reconstruction

Does notch size predict ACL insertion site size?

Systematic review on cadaveric studies of anatomic anterior cruciate ligament reconstruction

A matched pairs comparison of single- versus double-bundle anterior cruciate ligament reconstructions, clinical results and manual laxity testing