Reconstruction of the anterior cruciate- and anterolateral ligament deficient knee with a modified iliotibial graft reduces instability more than with an intra-articular hamstring graft

Purpose To compare knee kinematics before and after anterior cruciate ligament ACL reconstruction (ACL-R) using hamstring graft (HG) and a double-stranded iliotibial tract graft attached to Gerdy’s tubercle (providing an extra-articular anterolateral tenodesis) (named the modified iliotibial tract g...

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Bibliographic Details
Published in:Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA sports traumatology, arthroscopy : official journal of the ESSKA, 2020-08, Vol.28 (8), p.2526-2534
Main Authors: Eljaja, Salameh Belal, Konradsen, Lars, Siersma, Volkert Dirk, Athwal, Kiron, Amis, Andrew Arthur, Krogsgaard, Michael Rindom
Format: Article
Language:English
Subjects:
Anterior cruciate ligament
Anterior Cruciate Ligament - surgery
Anterior Cruciate Ligament Injuries - surgery
Anterior Cruciate Ligament Reconstruction - methods
Biomechanical Phenomena
Cadaver
Cadavers
Fascia Lata - transplantation
Grafting
Hamstring Tendons - transplantation
Humans
Joint Instability - surgery
Kinematics
Knee
Ligaments
Male
Medial Collateral Ligament, Knee - injuries
Medial Collateral Ligament, Knee - surgery
Medicine
Medicine & Public Health
Middle Aged
Optical tracking
Orthopedics
Range of Motion, Articular
Rotation
Tenodesis - methods
Tracking systems
Translation
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Summary:Purpose To compare knee kinematics before and after anterior cruciate ligament ACL reconstruction (ACL-R) using hamstring graft (HG) and a double-stranded iliotibial tract graft attached to Gerdy’s tubercle (providing an extra-articular anterolateral tenodesis) (named the modified iliotibial tract graft = MIT). Method Eighteen cadaveric knees were tested in a 6 degree of freedom kinematics rig. An optical tracking system recorded kinematics of the knee from 0 to 80 degrees of flexion applying no load, internal/external rotation (IR/ER), valgus/varus rotation (VGR/VRR), simulated pivot shift (SPS), anterior translation (AT) and posterior translation loads. The knee was tested before and after resection of the ACL and the anterolateral ligament (ALL), respectively; then after HG-ACL-R and MIT-ACL-R. Grafts were fixed at 20° of flexion. Results were compared to the intact knee. Results ACL resection resulted in a significant increase in AT ( p  
ISSN:0942-2056
1433-7347
DOI:10.1007/s00167-020-05850-8