Biomechanics of a double prosthetic ligament in the anterior cruciate deficient knee

Radford, W. J. P.; Amis, AA

doi:10.1302/0301-620x.72b6.2147184

Cited by 72 publications

(59 citation statements)

References 18 publications

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“…It may be more appropriate to reconstruct the ligaments with multiple strands, each with its own function at different flexion angles. There have been reports from studies indicating that the use of two-stranded reconstructions provided better results (Radford and Amis, 1990;Zaricznyj, 1987).…”

Section: Discussionmentioning

confidence: 99%

An inverse dynamics modeling approach to determine the restraining function of human knee ligament bundles

Mommersteeg

Huiskes

Blankevoort

et al. 1997

Journal of Biomechanics

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Abstract-During knee motion, the fiber bundles of ligaments are nonuniformly loaded in a recruitment pattern which is different for successive knee-joint positions. As a result, the restraining functions of these ligaments are variable. To analyze the relative restraint contributions of the fiber bundles in different knee-joint positions, a new method was developed. Its application was illustrated for the cruciate ligaments of one knee-joint specimen.The methods developed to estimate bundle forces comprise five steps. First, the three-dimensional motions of a knee specimen are measured for anterior-posterior forces, using Rdntgcn Stereophotogrammetric Analysis. Second, bone-ligament-bone tensile tests are performed to evaluate the mechanical properties of these structures in several relative orientations of the bones. Third, multiple fiber bundles are identified in each ligament, based on the main fiber orientations. Fourth, the nonlinear force-length relationship of each functional bundle, as defined by a stiffness and a recruitment parameter, is determined by combining the multidirectional tensile tests with a multiline-element ligament model. Finally, the information obtained is combined in a whole-joint computer model of the knee, to determine the internal forces in the initial kinematic experiment, using an inverse dynamics approach.The technique appeared to be extremely time consuming and technologically involved. However, it was demonstrated to be useful and effective. The preliminary results reveal that the fiber bundle restraints are extremely sensitive to the knee flexion angle and the restraining forces are highly variable within the ligaments. For both cruciate ligaments, a gradual transition was demonstrated in load transfer from the posterior bundles to the more anteriorly positioned ones during knee flexion. Furthermore, it appeared that relatively high forces were carried by only a few fiber bundles at each flexion angle. Based on these preliminary results, it is concluded that the determination of forces in multiple ligament bundles is important for the understanding of failure mechanisms of ligaments. In particular, alternate loading of different fiber bundles suggests that successful operative reconstruc tion of the cruciate ligaments may not be achieved simply by a one-bundle preparation.

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Section: Discussionmentioning

confidence: 99%

An inverse dynamics modeling approach to determine the restraining function of human knee ligament bundles

Mommersteeg

Huiskes

Blankevoort

et al. 1997

Journal of Biomechanics

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“…According to an ongoing study in the United States, an estimated 200,000 ACL reconstructions (ACLR) are performed annually, and the incidence of ACL injury is roughly one in 3000 per year [32]. Anatomic studies have demonstrated the anterior cruciate ligament consists of two functional bundles: the anteromedial (AM) and the posterolateral (PL) bundle whose nomenclature is related to their insertion in the tibial plateau [2,11,36]. In cadaveric studies, the AM bundle tightens during knee flexion, whereas the PL bundle slackens; in contrast, the PL bundle tightens during knee extension, whereas the AM bundle slackens [2,27,36].…”

Section: Introductionmentioning

confidence: 99%

Single- versus Double-bundle ACL Reconstruction: Is There Any Difference in Stability and Function at 3-year Followup?

Gobbi¹,

Mahajan²,

Karnatzikos³

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background Despite a number of studies comparing postoperative stability and function after anatomic doublebundle and single-bundle anterior cruciate ligament reconstruction (ACLR), it remains unclear whether double-bundle reconstruction improves stability or function. Questions/purposes We therefore asked whether patients having single-and double-bundle ACLR using semitendinosus (ST) alone differed with regard to (1) postoperative stability; (2) ROM; and (3) five functional scores. Methods We prospectively followed 60 patients with an isolated anterior cruciate ligament (ACL) injury. Thirty patients underwent single-bundle and 30 patients underwent double-bundle ACL reconstruction. Clinically we assessed stability and range of motion (ROM); anteroposterior stability was assessed by Rolimeter and rotational stability by a pivot shift test. Function was assessed by IKDC, Noyes, Lysholm, Marx, and Tegner activity scales.The minimum followup was 36 months (mean, 46.2 months; range, 36-60 months). Results Residual anteroposterior laxity at 3 years postoperatively was similar in both groups: 1.4 ± 0.3 mm versus 1.4 ± 0.2 mm, respectively. We observed no difference in the pivot shift test. ROM was similar in both groups, although double-bundle patients required more physical therapy sessions to gain full ROM. IKDC, Noyes, Lysholm, Marx, and Tegner scores were similar at final followup. Conclusion Double-bundle reconstruction of the ACL did not improve function or stability compared with singlebundle reconstruction.

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“…Controlled laboratory studies have shown superiority of DB ACL reconstructions in restoring knee kinematics for both translations and rotations compared with single bundle reconstruction [31,[33][34][35][36]. Radford and Amis showed that DB reconstruction controlled anterior laxity better than single bundle across the range of knee flexion [34].…”

Section: Biomechanical Studiesmentioning

confidence: 99%

“…Radford and Amis showed that DB reconstruction controlled anterior laxity better than single bundle across the range of knee flexion [34].…”

Section: Biomechanical Studiesmentioning

confidence: 99%

Anatomical single bundle anterior cruciate ligament reconstruction

Carmont

Scheffler

Spalding

et al. 2011

Curr Rev Musculoskelet Med

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Biomechanics of a double prosthetic ligament in the anterior cruciate deficient knee

Cited by 72 publications

References 18 publications

An inverse dynamics modeling approach to determine the restraining function of human knee ligament bundles

An inverse dynamics modeling approach to determine the restraining function of human knee ligament bundles

Single- versus Double-bundle ACL Reconstruction: Is There Any Difference in Stability and Function at 3-year Followup?

Anatomical single bundle anterior cruciate ligament reconstruction

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