Biomechanical Effects of Additional Anterolateral Structure Reconstruction With Different Femoral Attachment Sites on Anterior Cruciate Ligament Reconstruction

Author:

Katakura Mai12,Koga Hideyuki12,Nakamura Tomomasa1,Araki Daisuke3,Nagai Kanto3,Nishida Kyohei3,Kuroda Ryosuke3,Muneta Takeshi4

Affiliation:

1. Department of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan

2. Department of Orthopaedic Surgery, Hospital of Medicine, Tokyo Medical and Dental University, Tokyo, Japan

3. Department of Orthopaedic Surgery, Graduate School of Medicine, Kobe University, Kobe, Japan

4. National Hospital Organization Disaster Medical Center, Tachikawa-shi, Japan

Abstract

Background: Recently reported anterolateral structure reconstructions (ALSRs) to augment intra-articular anterior cruciate ligament reconstruction (ACLR) use various femoral attachment sites, and their biomechanical effects are still unknown. Hypothesis: ALSR concomitant with ACLR would control anterolateral rotational instability better than ACLR alone, and if ALSR had different femoral attachment sites, there would be different effects on its control of anterolateral rotational instability. Study Design: Controlled laboratory study. Methods: Twelve fresh-frozen hemipelvis lower limbs were included. Anterior tibial translation during the Lachman test and tibial acceleration during the pivot-shift test were measured with a 3-dimensional electromagnetic measurement system in situations with the (1) ACL and ALS intact, (2) ACL and ALS cut, (3) ALSR without ACLR (ALSR alone), (4) ACLR without ALSR (ACLR alone), and (5) ALSR with ACLR. Three femoral attachment sites were used for ALSR: F1, 2 mm anterior and 2 mm distal to the lateral epicondyle; F2, 4 mm posterior and 8 mm proximal to the lateral epicondyle; and F3, over-the-top position for the lateral extra-articular tenodesis. The Steel test and Wilcoxon signed rank test were used for statistical analysis. Results: Anterior tibial translation during the Lachman test in the ACL and ALS–cut state was significantly larger than it was in the ACL and ALS–intact state, while its difference disappeared after ACLR. As for the pivot-shift test, additional ALSR with F2 to ACLR significantly decreased the acceleration ( P = .046), although additional ALSR with F1 and F3 showed no significant effect. Conclusion: ALSR with the femoral attachment site 4 mm posterior and 8 mm proximal to the lateral epicondyle in addition to ACLR played a role in reducing anterolateral rotational instability the most effectively among the measured attachment sites. Clinical Relevance: The present data will contribute to determine the appropriate femoral attachment site for ALSR to better control anterolateral rotational instability after ACL reconstruction.

Publisher

SAGE Publications

Subject

Physical Therapy, Sports Therapy and Rehabilitation,Orthopedics and Sports Medicine

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3