Testing for isometry during reconstruction of the anterior cruciate ligament. Anatomical and biomechanical considerations.

Sapega, Alexander A.; Moyer, R.; Schneck, C; Komalahiranya, N

doi:10.2106/00004623-199072020-00015

Cited by 207 publications

(107 citation statements)

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“…Sapega et al 9 presented variations very similar to ours, mentioning that for this fiber bundle, he found a decrease of 5.4 mm in the length when the movement went from extension to flexion. A large number of the studies that we analyzed presented a standard movement similar to ours, ie, constant and decreasing, 13,22,23 although sometimes with small variations, such as in the study of Horwitz 15 who reported a small initial increase (0°-30°) followed by the relaxing of the fibers up to the 90° flexion.…”

Section: Posterior Fiber Bundlessupporting

confidence: 80%

“…7,8 Others have evaluated the resistance of cruciate ligaments by means of variable linear displacement transducers. 9 A universal force sensor placed in cadaver knees was used to describe the function of the ligaments or graft placement in various knee joint degrees of freedom. [10][11][12][13] The purpose of this study was to evaluate a low-cost and easily reproducible technique for biomechanical study in cadaver subjects.…”

Section: Introductionmentioning

confidence: 99%

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Experimental Evaluation of 3-Dimensional Kinematic Behavior of the Cruciate Ligaments

Júnior

Caldana

et al. 2007

Clinics

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PURPOSE:The purpose of this study was to evaluate a low-cost and easily reproducible technique for biomechanical studies in cadavers. In this kind of study, the natural effect of loading of the joint and shear forces are not taken into account. The objective is to describe the plastic deformation of the ligaments into 3-dimensional space. METHOD: For 18 intact human cadaver knees, the cruciate ligaments were divided into 3 fiber bundles, the tibial or femoral fixation points were marked, and 2 perpendicular different x-ray exposures were performed, thus obtaining radiographs of spatial projections of the bundle in 3 anatomic planes (frontal, sagittal, and transversal). From the measurements made on the x-ray films, we obtained the average distance between the 2 fixation points of the cruciate ligaments on the tibia and the femur at 4 different flexion angles. RESULTS:The distance between the fixation points of the medial and lateral fiber bundles of the cruciate ligaments did not change significantly during movement. There were, however, significant variations (P < .05) in the distance between the fixation points of the posterior fiber bundles of the anterior cruciate ligament and the anterior fiber bundles of the posterior cruciate ligament. CONCLUSIONS: This technique was efficient for demonstrating the plastic deformability of the cruciate ligaments. The results proceeding from this type of study can assist in the planning of physical rehabilitation programs.

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Section: Posterior Fiber Bundlessupporting

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Experimental Evaluation of 3-Dimensional Kinematic Behavior of the Cruciate Ligaments

Júnior

Caldana

et al. 2007

Clinics

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“…5, specimens 17 and 29). The AP length of the ACL attachment was 18 ± 2 mm (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23). This correlated to the size of the tibial plateau: r = 0.46, P = 0.0005 for ML width; r = 0.34, P = 0.0118 for AP depth.…”

Section: Resultsmentioning

confidence: 85%

“…1) by flexing and extending the knee to display their different tightening/slackening behaviour. In particular, the PL bundle becomes tight in knee flexion angles between 0° and 30°, whilst the AM bundle remains tight throughout flexion when an anterior displacement force is applied [2,5,19], allowing clear differentiation to be made between the two bundles. This is similar to that reported by Sakane et al [18] who used strain gauges to differentiate between the two bundles whilst passively flexing the knee.…”

Section: Introductionmentioning

confidence: 99%

The attachments of the anteromedial and posterolateral fibre bundles of the anterior cruciate ligament

Edwards

Bull

Amis

2007

Knee Surg Sports Traumatol Arthr

165

111

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The tibial attachments of the individual anteromedial (AM) and posterolateral (PL) fibre bundles and the entire attachment of the anterior cruciate ligament are described, relating them to consistent bony landmarks; 55 fresh-frozen specimens were measured. The fibre bundles were separated and excised at their attachments and their peripheries marked with a pen. Highresolution scaled digital photographs were taken of each dissected specimen and transferred onto a computer for analysis. A wide variation was found when using the posterior tibial axis, the anterior tibial surface and the medial tibial spine as reference points. The most consistent measurements used the tibial interspinous "over-the-back" ridge as a datum. The attachments of the PL and AM bundles were centred 10 ± 1 mm (mean ± SD) and 17 ± 2 mm anterior to the over-the-back ridge. They were 4 ± 1 and 5 ± 1 mm, respectively, lateral to the medial tibial spine border. The positions of 6 mm circles in the posterior-medial limits of the fibre bundles (representing tunnels in a double-tunnel reconstruction) were measured. The overall dimensions of the tibial plateaux correlated significantly with many measurements. The results from this study could be used to guide ACL reconstruction techniques.

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“…A very posterior position on the tibia should be avoided because it is the least isometric, causing too much "elongation" toward extension. [21][22][23] Furthermore, a posteriorly-placed tibial tunnel moves the graft towards a more vertically oriented proximal-distal orientation, and that is not efficient for withstanding anterior draw forces.…”

Section: Discussionmentioning

confidence: 99%

Validation of the 65° Howell Guide for Anterior Cruciate Ligament Reconstruction

Cuomo

Edwards

Giron

et al. 2006

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Testing for isometry during reconstruction of the anterior cruciate ligament. Anatomical and biomechanical considerations.

Cited by 207 publications

References 0 publications

Experimental Evaluation of 3-Dimensional Kinematic Behavior of the Cruciate Ligaments

Experimental Evaluation of 3-Dimensional Kinematic Behavior of the Cruciate Ligaments

The attachments of the anteromedial and posterolateral fibre bundles of the anterior cruciate ligament

Validation of the 65° Howell Guide for Anterior Cruciate Ligament Reconstruction

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