Anterior cruciate ligament graft tensioning versus knee stability

Positioning of the graft for anterior cruciate ligament (ACL) reconstruction and securing the graft at various degrees of knee flexion are interrelated factors when attempting to restore a knee's normal kinematics. The interrelationships between graft positioning on the femur and tibia (graft &...

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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, 1998, Vol.6 Suppl 1 (1), p.S38-S42
Main Authors: Friederich, N F, O'Brien, W R
Format: Article
Language:English
Subjects:
Anterior Cruciate Ligament - physiology
Anterior Cruciate Ligament - surgery
Biomechanical Phenomena
Humans
Isometrics
Joint stability
Kinematics
Knee Joint - physiology
Knees
Ligaments
Movement
Reconstructive Surgical Procedures - methods
Sports
Stability
Surgery
Tendons - physiology
Tendons - transplantation
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Summary:Positioning of the graft for anterior cruciate ligament (ACL) reconstruction and securing the graft at various degrees of knee flexion are interrelated factors when attempting to restore a knee's normal kinematics. The interrelationships between graft positioning on the femur and tibia (graft 'isometricity'); securing the graft at various positions of knee flexion; and the resulting restoration or disruption of the knee kinematics were studied on ten fresh frozen cadaveric knee specimens. Well placed ('isometric') grafts appeared to restore almost normal knee kinematics regardless of the position of the knee at the time of securing the grafts. This was, however, not the case in non-ideally placed grafts. 'Nonisometric' ACL substitutes which became taut in extension, overconstrained the knee if the graft was secured in flexion. If the same graft was secured in extension, increased joint laxity in flexion occurred. In contrast, 'nonisometric' ACL substitutes which became taut in flexion overconstrained the knee if the graft was secured in extension. If the same graft was secured in flexion, the graft became slack during extension.
ISSN:0942-2056
1433-7347
DOI:10.1007/s001670050221