Anterior-posterior and rotatory stability of single and double-bundle anterior cruciate ligament reconstructions

The Journal of Bone and Joint Surgery. American Volume
Keith L MarkolfDavid R McAllister

Abstract

Some surgeons presently reconstruct both the anteromedial and posterolateral bundles of the anterior cruciate ligament. The purposes of this study were to measure the abilities of single-bundle and anatomic double-bundle reconstructions to restore anteroposterior laxities and rotational kinematics to intact knee levels and to compare graft forces in reconstructed knees with forces in the native anterior cruciate ligament for the same loading conditions. Native anterior cruciate ligament force and tibial rotations were recorded during passive knee extension tests with and without applied tibial loads. The anteromedial and posterolateral bundles were reconstructed with patellar tendon tissue sized to fit tightly within 7-mm femoral tunnels. Testing was repeated with the anteromedial graft alone (single bundle), tensioned to restore anteroposterior laxity at 30 degrees of flexion, and with double-bundle grafts. For double-bundle reconstructions, the anteromedial graft was first tensioned as above and then the posterolateral graft was tensioned with use of one of four protocols: posterolateral tension = anteromedial tension at 10 degrees (DB1), posterolateral tension = anteromedial tension at 30 degrees (DB2), posterolateral tensio...Continue Reading

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