Two Different Knee Rotational Instabilities Occur With Anterior Cruciate Ligament and Anterolateral Ligament Injuries: A Robotic Study on Anterior Cruciate Ligament and Extra-articular Reconstructions in Restoring Rotational Stability

Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association
F R NoyesMartin S Levy

Abstract

To determine the effect of 2 extra-articular reconstructions on pivot-shift rotational stability and tibial internal rotation as a basis for clinical recommendations. A robotic simulator tested 15 cadaver knees. Group 1 (anterior cruciate ligament [ACL] cut) underwent ACL bone-patellar tendon-bone reconstruction followed by sectioning the anterolateral structures and an extra-articular, manual-tension iliotibial band (ITB) tenodesis. Group 2 (ACL intact) tested the rotational stabilizing effect of a low-tension ITB tenodesis before and after sectioning the anterolateral ligament/ITB structures. Lateral and medial tibiofemoral compartment translations and internal-external tibial rotations were measured under Lachman, 5N·m tibial rotation, and 2 pivot-shift simulations using 4-degree-of-freedom loading. Statistical equivalence was defined within 2 mm tibiofemoral compartment translation and 2° tibial rotation at P < .05. The bone-patellar tendon-bone ACL reconstruction (group 1) restored pivot-shift lateral compartment translation within 0.7 mm (95% confidence interval [CI], -0.6 to 1.9; P = .70) of normal. The internal rotation limit was not affected by ACL sectioning or reconstruction. After anterolateral ligament/ITB sectioni...Continue Reading

Citations

Jun 13, 2020·Archives of Orthopaedic and Trauma Surgery·Seong Hwan KimHan-Jun Lee
Oct 17, 2020·Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association·Frank R NoyesMichael Palmer
Apr 18, 2021·Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association·Kyle N KunzeJorge Chahla
Dec 7, 2021·Archives of Orthopaedic and Trauma Surgery·Hermann O MayrWolf C Prall

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