Three-Dimensional Tibiofemoral Kinematics of the Anterior Cruciate Ligament-Deficient and Reconstructed Knee during Walking

Georgoulis, Anastasios D.; Papadonikolakis, Anastasios; Papageorgiou, Christos D.; Mitsou, Argyris; Stergiou, Nicholas

doi:10.1177/03635465030310012401

Cited by 381 publications

(352 citation statements)

References 23 publications

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“…This is consistent with the results of studies of male athletes and others which document the increased occurrence of medial tibiofemoral knee OA after ACL tears, and of gait studies which have demonstrated elevated external adduction moments after ACL tears (1)(2)(3)25). Previous studies have shown that subjects with meniscal damage in addition to ACL rupture are more likely to develop knee OA than are those with isolated ACL rupture (4,26).…”

Section: Discussionsupporting

confidence: 90%

Cruciate ligament integrity in osteoarthritis of the knee

Hill¹,

Seo²,

Gale³

et al. 2005

Arthritis & Rheumatism

139

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Objective. To evaluate, using magnetic resonance imaging (MRI), the prevalence of anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) rupture in knees with symptomatic osteoarthritis (OA) compared with those without OA, and the relationship to pain and recalled injury.Methods. MRI and plain radiography of the knee were performed in a group of 360 subjects with painful knee OA (cases; 66.7% male, mean age 67.1 years) and 73 without knee pain (controls; 57.5% male, mean age 66.1 years). MRIs were read for the presence or absence of complete or partial ACL or PCL tear. Subjects with knee pain were asked to quantify severity of pain on a visual analog scale and to report whether they could recall a significant knee injury (requiring use of a cane or crutches). We compared the prevalence of ACL and PCL rupture in those with and those without knee pain and also evaluated whether, in cases, there was any association with recalled knee injury.Results. The proportion of cases who had complete ACL rupture was 22.8%, compared with 2.7% of controls (P ‫؍‬ 0.0004). PCL rupture was rare both in cases (0.6%) and in controls (0%). Cases with ACL rupture had more severe radiologic OA (P < 0.0001) and were more likely to have medial joint space narrowing (P < 0.0001) than cases with intact ACLs, but did not have higher pain scores. Among cases, only 47.9% of those with complete ACL tears reported a previous knee injury, compared with 25.9% of those without complete ACL tears (P ‫؍‬ 0.003).Conclusion. ACL rupture is more common among those with symptomatic knee OA compared with those without knee OA. Fewer than half of subjects with ACL rupture recall a knee injury, suggesting that this risk factor for knee OA is underrecognized.

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Section: Discussionsupporting

confidence: 90%

Cruciate ligament integrity in osteoarthritis of the knee

Hill¹,

Seo²,

Gale³

et al. 2005

Arthritis & Rheumatism

139

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“…Recent cadaver studies have suggested a graft placed near the center of the ACL more closely restores knee kinematics than an anteriorly placed graft [35,44]. Therefore, anatomic graft placement is likely important given the inability of current reconstruction techniques to restore normal kinematics and is believed an important factor contributing to the long-term development of osteoarthritis after ACL reconstruction [17,39,48,50]. We compared the ability of the transtibial technique and a tibial tunnel independent technique to anatomically place the femoral tunnel near the center of the ACL footprint and hypothesized the independent technique would allow for closer placement of the guide pin to the center of the ACL compared with the transtibial technique.…”

Section: Discussionmentioning

confidence: 99%

“…Although more patient studies are needed to evaluate the effects of ACL reconstruction on kinematics under physiologic loading conditions, these cadaver studies suggest that more anatomic placement of the femoral tunnel might help to more closely restore normal knee motion. This is likely important because abnormal knee kinematics generally are believed an import factor in the degenerative changes observed after ACL injury [17,34,39,50,52,54].…”

Section: Discussionmentioning

confidence: 99%

“…A vertically oriented graft is unlikely to restore the oblique orientation of the ACL [9,32,44,54] and might provide inadequate restraint to the increased internal rotation [4,12,17] and medial tibial translation [12,31] observed in patients with ACL deficiency. Altered kinematics after ACL injury are thought to predispose the knee to degenerative changes [4,17,39,40,50].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, studies have suggested that the ability of current reconstruction techniques to prevent degenerative changes compared with nonoperative treatment is limited [11,[13][14][15]36]. Although many mechanisms likely contribute to this degeneration (for example, traumatic injury to other soft tissues at the time of ACL rupture), numerous authors suggest the inability of the reconstruction to restore normal joint kinematics is an important factor [17,34,39,50,53,54].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Reconstruction Technique Affects Femoral Tunnel Placement in ACL Reconstruction

Kaseta

DeFrate

Charnock

et al. 2008

Clinical Orthopaedics &Amp; Related Research

136

143

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Grafts placed too anteriorly on the femur are reportedly a common cause of failure in anterior cruciate ligament reconstruction. Some studies suggest more anatomic femoral tunnel placement improves kinematics. The ability of the transtibial technique and a tibial tunnel-independent technique (placed transfemorally outside-in) to place the guide pin near the center of the femoral attachment of the anterior cruciate ligament was compared in 12 cadavers. After arthroscopic placement of the guide pins, the femur was dissected and the three-dimensional geometry of the femur, anterior cruciate ligament footprint, and positions of each guide pin were measured. The transtibial guide-pin placement was 7.9 ± 2.2 mm from the center of the footprint (near its anterior border), whereas the independent technique positioned the guide pin 1.9 ± 1.0 mm from the center. The center of the footprint was within 2 mm of an anteroposterior line through the most posterior border of the femoral cartilage in the notch and a proximodistal line through the proximal margin of the cartilage at the capsular reflection. More accurate placement of the femoral tunnel might reduce the incidence of graft failure and might reduce long-term degeneration observed after reconstruction although both would require clinical confirmation.

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