Can Joint Contact Dynamics Be Restored by Anterior Cruciate Ligament Reconstruction?

Abstract

Background Rotational kinematics has become an important consideration after ACL reconstruction because of its possible influence on knee degeneration. However, it remains unknown whether ACL reconstruction can restore both rotational kinematics and normal joint contact patterns, especially during functional activities. Questions/purposes We asked whether knee kinematics (tibial anterior translation and axial rotation) and joint contact mechanics (tibiofemoral sliding distance) would be restored by double-bundle (DB) or single-bundle (SB) reconstruction.Methods We retrospectively studied 17 patients who underwent ACL reconstruction by the SB (n = 7) or DB (n = 10) procedure. We used dynamic stereo x-ray to capture biplane radiographic images of the knee during downhill treadmill running. Tibial anterior translation, axial rotation, and joint sliding distance in the medial and lateral compartments were compared between reconstructed and contralateral knees in both SB and DB groups. Results We observed reduced anterior tibial translation and increased knee rotation in the reconstructed knees compared to the contralateral knees in both SB and DB groups. The mean joint sliding distance on the medial compartment was larger in the reconstructed knees than in the contralateral knees for both the SB group (9.5 ± 3.9 mm versus 7.5 ± 4.3 mm) and the DB group (11

Should Return to Sport be Delayed Until 2 Years After Anterior Cruciate Ligament Reconstruction? Biological and Functional Considerations

“…[98] Dual fluoroscopy and dynamic stereo-radiography is becoming more widely accessible because it provides better precision and more reliability than the use of high-speed cameras or marker based motion capture systems. [98] Hoshino and colleagues[99] investigated whether knee kinematics and joint contact mechanics can be restored after ACLR with a double-bundle or single-bundle graft using dynamic stereo x-ray to capture biplane radiographic images. The athletes were on average a little more than one year out from ACLR and were performing downhill treadmill running.…”

“…The athletes were on average a little more than one year out from ACLR and were performing downhill treadmill running. [99] The study concluded that neither ACLR procedure restored normal knee kinematics or medial joint sliding. [99] In addition, developments in quantitative magnetic resonance imaging (MRI) have allowed researchers to evaluate the composition and structures within the knee.…”

Biomechanical Outcomes of Bridge-enhanced Anterior Cruciate Ligament Repair Are Influenced by Sex in a Preclinical Model

“…Women are at increased risk (up to 10-fold) for ACL injury in comparison to men when playing the same sport [29]. Despite reasonable success of ACL reconstruction, the current gold standard of treatment, in restoring the gross stability of the ACL-deficient knee, it fails to restore normal joint kinematics and kinetics [8,22,24,25,43,52]. Moreover, ACL reconstruction is associated with reduced activity level [5], an increased rate of secondary injury [48], and high risk of posttraumatic osteoarthritis (OA), up to 74%, even with advanced anatomic reconstruction techniques [13,32,33,40,50,56].…”

Knee Contact Force Asymmetries in Patients Who Failed Return-to-Sport Readiness Criteria 6 Months After Anterior Cruciate Ligament Reconstruction

“…Nonetheless, the mechanical environment of the knee after an ACL injury and reconstruction is not well understood. While altered knee contact kinematics are known to exist after ACL injuries 3,8,16,28 and can persist after reconstruction, 1,10,23 joint contact forces in the ACL-injured knee are less well described. Joint contact force is the magnitude of load that is applied perpendicular to the articular surface and represents the compressive loading of the joint as a whole.…”