Reconstruction does not reduce tibial translation in the cruciate-deficient knee

Beard, D; Murray, D.W.; Gill, H. S.; Price, Andrew; Rees, Jonathan; Alfaro-Adrián, J.; Dodd, Christopher

doi:10.1302/0301-620x.83b8.11320

Cited by 37 publications

(33 citation statements)

References 40 publications

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“…Previous studies suggest that symptoms and laxity are unrelated [26,27]. Contrary to these results, our study showed negative correlation with knee specific and general health related questionnaires.…”

Section: Discussioncontrasting

confidence: 99%

A descriptive study of potential effect of anterior tibial translation, femoral tunnel and anterior cruciate ligament graft inclination on clinical outcome and degenerative changes

Snoj

Zupanc

Stražar

et al. 2017

International Orthopaedics (SICOT)

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Introduction There is no evidence that anatomically correct anterior cruciate ligament reconstruction (ACLR) offers lower rate of degenerative changes development or that it would lead to a better outcome. The significance and understanding of the abnormal anterior tibial translation (ATT) in ACLR patients is yet to be established. Methods Sixty subjects (40 patients at 5.9 years after ACLR, 20 healthy controls) underwent 3 T MRI. Quantitative cartilage T2 mapping and morphological whole organ magnetic resonance imaging score (WORMS) evaluation was performed. Self-reported questionnaires were used for subjective clinical evaluation. Correlations were calculated with the following MRI measurements; femoral tunnel inclination, ACL graft inclination, lateral and medial compartment ATT. Results In the ACLR group positive correlation was found between the patellar cartilage T2 values and sagittal ACL graft inclination. In the ACLR group lateral compartment ATT showed negative correlation with ACL graft inclination and subjective clinical evaluation, and positive correlation with morphological degenerative changes. Femoral tunnel showed positive correlation with ACL graft inclination in the same plane. Conclusions Increased ATT offers worse clinical outcome and increased rate of degenerative changes. Furthermore, ATT is affected by the ACL inclination. Inclination of the drilling tunnel affects ACL graft inclination; thereby independent drilling techniques provide superior results of anatomical ACL graft positioning.

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Section: Discussioncontrasting

confidence: 99%

A descriptive study of potential effect of anterior tibial translation, femoral tunnel and anterior cruciate ligament graft inclination on clinical outcome and degenerative changes

Snoj

Zupanc

Stražar

et al. 2017

International Orthopaedics (SICOT)

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“…This corroborates the findings of a previous study [3] on a similar group of subjects during walking. The pattern of sagittal plane displacement demonstrated in this study appears consistent with that of Lafortune et al [25] who studied 3-D kinematics of the knee during walking, using markers attached to intra-cortical traction pins.…”

Section: Discussionsupporting

confidence: 92%

“…The limitations of a previously described study by Holden et al were addressed by using an improved method for tracking the markers. Use of the contralateral limb as a control, as used by Beard et al [3] reduces the effects of construct related variability such as skin movement.…”

mentioning

confidence: 99%

“…Since methods of analysis become increasingly inaccurate as the subject moves faster, most studies have been limited to analysing subjects performing simple tasks such as straight-line walking or a step-up [2][3][4][5][6][7]. However, activities such as straight-line walking put relatively little demand on joints, and it is recognised that investigating more stressful activities, such as running and cutting, is necessary to understand how the functional kinematics of the knee are altered after ACL rupture.…”

mentioning

confidence: 99%

“…Another more closely related work [3] studied unilaterally ACLD patients whilst walking. Patellar-tendon angle was used to calculate anterior tibial translation in the sagittal plane.…”

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confidence: 99%

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In vivo kinematics of the ACL-deficient limb during running and cutting

Waite

Beard

Dodd

et al. 2005

Knee Surg Sports Traumatol Arthrosc

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Anterior cruciate ligament-deficient (ACLD) knee kinematics during high-demand activities are poorly understood. We have devised a new method, using gait analysis, to more accurately assess 3-D in vivo kinematics of the knee. This has enabled us to report on how knee kinematics are altered after ACL rupture, during running and cutting. Fifteen unilaterally ACLD subjects were assessed using a 12-camera 100 Hz VICON motion analysis system. Simultaneous electromyographical (EMG) recordings were used to assess the role of the sensorimotor system in knee joint stability. All subjects were able to perform demanding cutting activities without experiencing symptoms of instability. We found that running produces fundamentally different kinematic patterns to those seen during walking. Tibiofemoral translation in the anteroposterior plane is controlled to within normal limits. Conversely, coronal translation and rotation are poorly controlled. We found that the injured leg was maintained in greater extension during the stance phase of all running activities studied and that the quadriceps muscle was active for longer during this period. We believe that low-demand activities, such as walking, do not reproduce kinematics relevant to ACLD instability and that future investigations into functional instability in the ACLD knee should focus on coronal and rotational displacements.

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