Abstract:DIS with a preload of 80 N restores knee joint kinematics comparable to that of an ACL-intact knee and is therefore capable of providing knee joint stability during ACL healing. DIS therefore provides a new technique for primary ACL repair with superior biomechanical properties in comparison with other techniques that have been described previously, although further clinical studies are required to determine its usefulness in clinical settings.
“…Paired knees of four donors were used resulting in a reduced statistical power and overall sample size as left and right knees of the same donor might show similar behavior. The translational knee laxity was measured with a clinically widely used instrument (Rolimeter) and, although the anteriorly directed force executed by the examiner was standardized to 134 N in order to reduce inter-tester variability, variability can still occur (Herbort et al 2013; Loh et al 2003; Petersen et al 2007; Schliemann et al 2015). …”
Section: Discussionmentioning
confidence: 99%
“…Five pulleys, oriented perpendicular to the 0°, 15°, 30°, 60° and 90° position of the tibia, transmitted the 134 N force to the tibial tuberosity and simulated the situation during a clinical examination of the knee joint with a KT-1000 device (Fig. 3) (Herbort et al 2013; Loh et al 2003; Petersen et al 2007; Schliemann et al 2015). Fig.…”
Section: Methodsmentioning
confidence: 99%
“…In a static biomechanical study Schliemann et al have shown that DIS reduced knee joint laxity close to the pre-injury level (Schliemann et al 2015). Moreover, Kohl et al reported that it established and maintained close contact between the two ends of the ruptured ACL (Kohl et al 2014).…”
BackgroundDynamic augmentation of anterior cruciate ligament tears seems to reduce anteroposterior knee translation close to the pre-injury level. The aim of the present study is to biomechanically investigate the course of translation during a simulated early post-operative phase. It is hypothesized that anteroposterior translation is maintained at the immediate post-operative level over a simulated rehabilitation period of 50’000 gait cycles.MethodsEight fresh-frozen human cadaveric knee joints from donors with a mean age of 35.5 (range 25–40) years were subjected to 50’000 cycles of 0°-70°-0° flexion-extension movements in a custom-made test setup. Anteroposterior translation was assessed with simulated Lachman/KT-1000 testing in 0°, 15°, 30°, 60° and 90° of flexion in knee joints treated with the novel technique initially and after 50’000 cycles testing. Statistical analysis was performed using the Wilcoxon Signed-Rank Test. The level of significance was set at p = 0.05.ResultsAnteroposterior translation changed non-significantly for all flexion angles between cycle 0 and 50’000 (p = 0.39 to p = 0.89), except for 30° flexion, where a significant increase by 1.4 mm was found (p = 0.03).ConclusionIncrease in anteroposterior translation of knees treated with this dynamic augmentation procedure is low. The procedure maintains translation close to the immediate post-operative level over a simulated rehabilitation period of 50’000 gait cycles and therefore supports anterior cruciate ligament repair during biological healing.
“…Paired knees of four donors were used resulting in a reduced statistical power and overall sample size as left and right knees of the same donor might show similar behavior. The translational knee laxity was measured with a clinically widely used instrument (Rolimeter) and, although the anteriorly directed force executed by the examiner was standardized to 134 N in order to reduce inter-tester variability, variability can still occur (Herbort et al 2013; Loh et al 2003; Petersen et al 2007; Schliemann et al 2015). …”
Section: Discussionmentioning
confidence: 99%
“…Five pulleys, oriented perpendicular to the 0°, 15°, 30°, 60° and 90° position of the tibia, transmitted the 134 N force to the tibial tuberosity and simulated the situation during a clinical examination of the knee joint with a KT-1000 device (Fig. 3) (Herbort et al 2013; Loh et al 2003; Petersen et al 2007; Schliemann et al 2015). Fig.…”
Section: Methodsmentioning
confidence: 99%
“…In a static biomechanical study Schliemann et al have shown that DIS reduced knee joint laxity close to the pre-injury level (Schliemann et al 2015). Moreover, Kohl et al reported that it established and maintained close contact between the two ends of the ruptured ACL (Kohl et al 2014).…”
BackgroundDynamic augmentation of anterior cruciate ligament tears seems to reduce anteroposterior knee translation close to the pre-injury level. The aim of the present study is to biomechanically investigate the course of translation during a simulated early post-operative phase. It is hypothesized that anteroposterior translation is maintained at the immediate post-operative level over a simulated rehabilitation period of 50’000 gait cycles.MethodsEight fresh-frozen human cadaveric knee joints from donors with a mean age of 35.5 (range 25–40) years were subjected to 50’000 cycles of 0°-70°-0° flexion-extension movements in a custom-made test setup. Anteroposterior translation was assessed with simulated Lachman/KT-1000 testing in 0°, 15°, 30°, 60° and 90° of flexion in knee joints treated with the novel technique initially and after 50’000 cycles testing. Statistical analysis was performed using the Wilcoxon Signed-Rank Test. The level of significance was set at p = 0.05.ResultsAnteroposterior translation changed non-significantly for all flexion angles between cycle 0 and 50’000 (p = 0.39 to p = 0.89), except for 30° flexion, where a significant increase by 1.4 mm was found (p = 0.03).ConclusionIncrease in anteroposterior translation of knees treated with this dynamic augmentation procedure is low. The procedure maintains translation close to the immediate post-operative level over a simulated rehabilitation period of 50’000 gait cycles and therefore supports anterior cruciate ligament repair during biological healing.
“…It pushes the proximal tibia in a constant posterior drawer position (50 to 80N) in any degree of flexion, ensuring that the two ligament stumps are kept as close to each other as possible at all times to enable mechanically stable ACL healing. 15 The presence of the metallic implant in the tibia after DIS may complicate MRI follow-up in these patients and usually necessitates the use of metal artifact reduction sequences (e.g., slice encoding for metal artifact reduction 16 ).…”
The aim of anterior cruciate ligament (ACL) reconstruction is to restore normal function of the knee, but unfortunately abnormal kinematics and a predisposition to knee osteoarthritis occur in a significant percentage of patients. So there is an ongoing need to improve treatment options and long-term outcome of patients with a ruptured ACL. With the recent advancements in the field of ACL tissue engineering, the focus of treatment for ACL injuries is changing from resection and reconstruction toward repair and regeneration. Several new ACL repair methods were recently introduced as an alternative to traditional ACL reconstructive procedures. Radiologists must become familiar with these new surgical methods to interpret their appearance correctly on postoperative imaging studies. This article provides an overview of the latest advancements in ACL surgical methods and discusses the role of imaging to assess the postoperative ACL including both standard and advanced imaging methods.
“…Not surprisingly, a recent case series of arthroscopically repaired proximal ACL tears has reported excellent results [5], and it seems that there is a recent resurgence of interest in primary ACL repair [1,4,31,34]. Several advantages of ACL preservation with primary repair exist, when compared to ACL reconstruction, including maintaining proprioceptive function [25,28] and the native ACL kinematics [27].…”
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
