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The American Journal of Sports Medicine 30:660-666 (2002)
© 2002 American Orthopaedic Society for Sports Medicine

Biomechanical Analysis of an Anatomic Anterior Cruciate Ligament Reconstruction

Masayoshi Yagi, MD, Eric K. Wong, MS, Akihiro Kanamori, MD, Richard E. Debski, PhD, Freddie H. Fu, MD and Savio L-Y. Woo, PhD*

From the Musculoskeletal Research Center, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania

* Address correspondence and reprint requests to Savio L-Y. Woo, PhD, Musculoskeletal Research Center, Department of Orthopaedic Surgery, University of Pittsburgh, E1641 Biomedical Science Tower, 210 Lothrop Street, POB 71199, Pittsburgh, PA 15213

Background: The focus of most anterior cruciate ligament reconstructions has been on replacing the anteromedial bundle and not the posterolateral bundle.

Hypothesis: Anatomic two-bundle reconstruction restores knee kinematics more closely to normal than does single-bundle reconstruction.

Study Design: Controlled laboratory study.

Methods: Ten cadaveric knees were subjected to external loading conditions: 1) a 134-N anterior tibial load and 2) a combined rotatory load of 5-N·m internal tibial torque and 10-N·m valgus torque. Resulting knee kinematics and in situ force in the anterior cruciate ligament or replacement graft were determined by using a robotic/universal force-moment sensor testing system for 1) intact, 2) anterior cruciate ligament deficient, 3) single-bundle reconstructed, and 4) anatomically reconstructed knees.

Results: Anterior tibial translation for the anatomic reconstruction was significantly closer to that of the intact knee than was the single-bundle reconstruction. The in situ force normalized to the intact anterior cruciate ligament for the anatomic reconstruction was 97%± 9%, whereas the single-bundle reconstruction was only 89%± 13%. With a combined rotatory load, the normalized in situ force for the single-bundle and anatomic reconstructions at 30° of flexion was 66%± 40%and 91%± 35%, respectively.

Conclusions: Anatomic reconstruction may produce a better biomechanical outcome, especially during rotatory loads.

Clinical Relevance: Results may lead to the use of a two-bundle technique.




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