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ACL reconstruction and biomechanics

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https://www.readbyqxmd.com/read/29761106/current-strategies-and-future-directions-to-optimize-acl-reconstruction-in-adolescent-patients
#1
Dustin Jon Richter, Roger Lyon, Scott Van Valin, Xue-Cheng Liu
The incidence of anterior cruciate ligament (ACL) injuries in the pediatric population has risen in recent years. These injuries have historically presented a management dilemma in skeletally immature patients with open physes and significant growth remaining at time of injury. While those nearing skeletal maturity may be treated with traditional, transphyseal adult techniques, these same procedures risk iatrogenic damage to the growth plates and resultant growth disturbances in younger patients with open physes...
2018: Frontiers in Surgery
https://www.readbyqxmd.com/read/29729766/editorial-commentary-medial-meniscal-ramp-lesions-lessons-learned-from-the-past-in-the-pursuit-of-evidence
#2
EDITORIAL
Romain Seil
Thirty-five years after their initial description, ramp lesions of the medial meniscus in anterior cruciate ligament (ACL)-deficient knees are slowly being rediscovered. Routinely repaired in open ACL and peripheral reconstructions before the era of arthroscopic ACL reconstruction, ramp lesions have been largely ignored in the last 2 decades. Following the growing number of studies analyzing the causes of residual laxity after ACL reconstructions over the last decade, ramp lesions are increasingly being implicated, and thus investigated, but remain poorly understood...
May 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29727018/the-improvement-of-bone-tendon-fixation-by-porous-titanium-interference-screw-a-rabbit-animal-model
#3
Pei-I Tsai, Chih-Yu Chen, Shu-Wei Huang, Kuo-Yi Yang, Tzu-Hung Lin, San-Yuan Chen, Jui-Sheng Sun
The interference screw is a widely used fixation device in the anterior cruciate ligament (ACL) reconstruction surgeries. Despite the generally satisfactory results, problems of using interference screws were reported. By using additive manufacturing (AM) technology, we developed an innovative titanium alloy (Ti6 Al4 V) interference screw with rough surface and inter-connected porous structure designs to improve the bone-tendon fixation. An innovative Ti6 Al4 V interference screws were manufactured by AM technology...
May 4, 2018: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/29722123/a-tricalcium-phosphate-polyether-ether-ketone-anchor-bionic-fixation-device-for-anterior-cruciate-ligament-reconstruction-safety-and-efficacy-in-a-beagle-model
#4
Genwen Mao, Zili Qin, Zheng Li, Xiang Li, Yusheng Qiu, Weiguo Bian
The goal of this study was to develop a bionic fixation device based on the use of a tricalcium phosphate/polyether ether ketone anchor and harvesting of the ulnar carpal flexor muscle tendon for application as a ligament graft in a beagle anterior cruciate ligament (ACL) reconstruction model, with the goal of accelerating the ligament graft-to-bone tunnel healing and providing a robust stability through exploration of this new kind of autologous ligament graft. The safety and efficacy of this fixation device were explored 3 and 6 months after surgery in a beagle ACL reconstruction model using biomechanical tests and comprehensive histological observation...
May 2, 2018: Journal of Biomedical Materials Research. Part B, Applied Biomaterials
https://www.readbyqxmd.com/read/29705749/quadriceps-tendon-autograft-for-arthroscopic-knee-ligament-reconstruction-use-it-now-use-it-often
#5
REVIEW
Andrew J Sheean, Volker Musahl, Harris S Slone, John W Xerogeanes, Danko Milinkovic, Christian Fink, Christian Hoser
Traditional bone-patellar tendon-bone and hamstring tendon ACL grafts are not without limitations. A growing body of anatomic, biomechanical and clinical data has demonstrated the utility of quadriceps tendon autograft in arthroscopic knee ligament reconstruction. The quadriceps tendon autograft provides a robust volume of tissue that can be reliably harvested, mitigating the likelihood of variably sized grafts and obviating the necessity of allograft augmentation. Modern, minimally invasive harvest techniques offer the advantages of low rates of donor site morbidity and residual extensor mechanism strength deficits...
April 28, 2018: British Journal of Sports Medicine
https://www.readbyqxmd.com/read/29700560/greater-fear-of-reinjury-is-related-to-stiffened-jump-landing-biomechanics-and-muscle-activation-in-women-after-acl-reconstruction
#6
Stephanie M Trigsted, Dane B Cook, Kristen A Pickett, Lisa Cadmus-Bertram, Warren R Dunn, David R Bell
PURPOSE: Fear of reinjury is an important factor in determining who returns to sport following anterior cruciate ligament reconstruction (ACLR). Evidence from other musculoskeletal injuries indicates fear of reinjury may be related to stiffened movement patterns observed in individuals following ACLR. The relationship between fear of reinjury and performance on dynamic tasks, however, has not been investigated. Therefore, the purpose of this study was to investigate the relationship between fear of reinjury and jump-landing biomechanics...
April 26, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29671697/a-biomechanical-comparison-of-dominant-and-non-dominant-limbs-during-a-side-step-cutting-task
#7
Christine D Pollard, Marc F Norcross, Sam T Johnson, Amanda E Stone, Eunwook Chang, Mark A Hoffman
Numerous studies have investigated anterior cruciate ligament (ACL) injury risk by examining gender differences in knee and hip biomechanics during a side-step cutting manoeuvre since it is known that ACL injury often occurs during such a task. Recent investigations have also examined lower extremity (LE) biomechanics during side-step cutting in individuals following ACL reconstruction (ACLR). Common research practice is to compare knee and hip biomechanics of the dominant limb between groups but this can add considerable complexity for clinicians and researchers...
April 19, 2018: Sports Biomechanics
https://www.readbyqxmd.com/read/29655901/in-vivo-heterotopic-culturing-of-prefabricated-tendon-grafts-with-mechanical-stimulation-in-a-sheep-model
#8
M Petri, P Lu, M Omar, M Ettinger, C Krettek, C Neunaber, M Jagodzinski
BACKGROUND: The goal of this study is to investigate the biomechanical and histological properties of in vivo heterotopically prefabricated cruciate ligament replacement grafts with and without mechanical stimulation. The clinical goal is to heterotopically prefabricate a bone-tendon-bone graft for anterior cruciate ligament reconstruction, which allows rapid ingrowth and early full weight bearing. METHODS: In a sheep model, eight quadriceps tendon grafts were harvested and introduced into culture chambers at their proximal and distal ends...
April 11, 2018: Knee
https://www.readbyqxmd.com/read/29624874/biological-and-biomechanical-evaluation-of-autologous-tendon-combined-with-ligament-advanced-reinforcement-system-artificial-ligament-in-a-rabbit-model-of-anterior-cruciate-ligament-reconstruction
#9
Xin-Min Wang, Gang Ji, Xiao-Meng Wang, Hui-Jun Kang, Fei Wang
OBJECTIVE: To compare the biomechanical and histological changes in a rabbit model after reconstructing the anterior cruciate ligament (ACL) with solely autologous tendon and with autologous tendon combined with the ligament advanced reinforcement system (LARS) artificial ligament. METHODS: Anterior cruciate ligament reconstruction was performed in 72 knees from 36 healthy New Zealand white rabbits (bodyweight, 2500-3000 g). The Achilles tendons were harvested bilaterally...
April 6, 2018: Orthopaedic Surgery
https://www.readbyqxmd.com/read/29623378/acl-graft-compression-a-method-to-allow-reduced-tunnel-sizes-in-acl-reconstruction
#10
Breck R Lord, Henry B Colaco, Chinmay M Gupte, Adrian J Wilson, Andrew A Amis
PURPOSE: A common problem during ACL reconstruction is asymmetry of proximal-distal graft diameter leading to tunnel upsizing and graft-tunnel mismatch. Compression downsizing provides a graft of uniform size, allowing easy passage into a smaller tunnel. The purpose of this study was to quantify the graft compression technique and its effects on graft biomechanics and stability. It was hypothesised that compression downsizing would significantly reduce cross-sectional area (CSA); that no significant changes in graft biomechanics would occur; graft fixation stability would be improved...
April 5, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29622242/editorial-commentary-the-anterolateral-ligament-the-emperor-s-new-clothes
#11
EDITORIAL
Andy Williams
In the following editorial commentary, the lateral soft tissues responsible for resisting the pivot shift phenomenon with the anterior cruciate ligament (ACL) are considered. The recent history of the anterolateral ligament (ALL) has led to rapid adoption of surgical techniques that have often not been investigated with scientific due process. A step-by-step approach starts with biomechanical testing to establish the anatomy and biomechanical characteristics of soft tissue structures and questions the importance of the ALL and proposes a more important role for the iliotibial band (ITB) passing between attachments to the distal lateral femur and tibia...
April 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29620913/into-tunnel-repair-versus-onto-surface-repair-for-rotator-cuff-tears-in-a-rabbit-model
#12
Xiaoxi Li, Peng Shen, Wei Su, Song Zhao, Jinzhong Zhao
BACKGROUND: Clinically, onto-surface repair is commonly used for rotator cuff tears. The retear rate after rotator cuff repair (RCR) is relatively high, with failure occurring mostly at the tendon-bone connection site. For anterior cruciate ligament (ACL) reconstruction, into-tunnel reconstruction is commonly employed. The retear rate after ACL reconstruction is relatively low, with retears seldom occurring at the tendon-bone interface. No study on into-tunnel RCR has been conducted. HYPOTHESIS: Into-tunnel RCR could promote fibrocartilage regeneration at the tendon-bone interface and has biomechanical advantage over onto-surface repair in a rabbit rotator cuff tear model...
April 1, 2018: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29574546/graft-bending-angle-affects-allograft-tendon-maturity-early-after-anterior-cruciate-ligament-reconstruction
#13
Linhai Chen, Yibing Wu, Guanghao Lin, Peng Wei, Zaohui Ye, Yangjian Wang, Tiantian Ren
PURPOSE: The aim of this study was to clarify the association of the anterior cruciate ligament (ACL) graft bending angle and graft maturity of autograft and allograft tendons using high-resolution MRI. METHODS: Patients with unilateral ACL reconstruction were invited to participate in this study, and they were examined using a 3.0-T MRI scan at 3, 6 and 12 months after the operation. Anatomic single-bundle ACL reconstruction was performed on 48 patients using the trans-portal technique, including 28 with autograft hamstring tendons and 20 with allograft tendons...
March 24, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29519162/does-the-graft-tunnel-friction-influence-knee-joint-kinematics-and-biomechanics-after-anterior-cruciate-ligament-reconstruction-a-finite-element-study
#14
Chao Wan, Zhixiu Hao
Graft tissues within bone tunnels remain mobile for a long time after anterior cruciate ligament (ACL) reconstruction. However, whether the graft-tunnel friction affects the finite element (FE) simulation of the ACL reconstruction is still unclear. Four friction coefficients (from 0 to 0.3) were simulated in the ACL-reconstructed joint model as well as two loading levels of anterior tibial drawer. The graft-tunnel friction did not affect joint kinematics and the maximal principal strain of the graft. By contrast, both the relative graft-tunnel motion and equivalent strain for the bone tunnels were altered, which corresponded to different processes of graft-tunnel integration and bone remodeling, respectively...
February 2018: Computer Methods in Biomechanics and Biomedical Engineering
https://www.readbyqxmd.com/read/29466066/effect-of-graft-type-on-balance-and-hop-tests-in-adolescent-males-following-anterior-cruciate-ligament-reconstruction
#15
Dai Sugimoto, Benton E Heyworth, Jeffery J Brodeur, Dennis E Kramer, Mininder S Kocher, Lyle J Micheli
CONTEXT: Recent epidemiology studies indicated a steady increase of anterior cruciate ligament (ACL) injury in young athletes. ACL reconstruction (ACLR) is currently a standard of the care, but effect of ACLR graft including bone patellar tendon bone (BTB), hamstring tendon (HT), or iliotibial band (ITB) on balance and hop performance is understudied. OBJECTIVE: To compare balance and hop deficits between uninvolved and reconstructed limbs in each autograft type (aim 1) and among the three autograft groups (aim 2)...
February 21, 2018: Journal of Sport Rehabilitation
https://www.readbyqxmd.com/read/29450567/coronal-tibial-anteromedial-tunnel-location-has-minimal-effect-on-knee-biomechanics
#16
Shigehiro Asai, Donghwi Kim, Yuichi Hoshino, Chan-Woong Moon, Akira Maeyama, Monica Linde, Patrick Smolinski, Freddie H Fu
PURPOSE: Studies have found anatomic variation in the coronal position of the insertion site of anteromedial (AM) bundle of the anterior cruciate ligament (ACL) on the tibia, which can lead to questions about tunnel placement during ACL reconstruction. The purpose of this study was to determine how mediolateral placement of the tibial AM graft tunnel in double-bundle ACL reconstructions affects knee biomechanics. METHODS: Two different types of double-bundle ACL reconstructions were performed...
February 15, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29440951/double-whip-stitch-for-free-graft-femoral-fixation-in-acl-reconstruction-experimental-study-on-porcine-model
#17
Cristian Tudor Buescu, Cristian Mircea Dudescu, Sergiu Caterev, Dan Gheorghe Osvald Lucaciu
Background and aims: Using free quadriceps tendon graft for anterior cruciate ligament (ACL) reconstruction has become more popular in the last years due to the low morbidity at the harvest site and biomechanical and structural properties similar to other types of graft (hamstring and patellar tendons). As long as the tibial tunnel fixation with interference screws is considered the standard fixation, femoral fixation is still an open subject. Even though the most common type of femoral tunnel fixation are the cortical suspension devices, the type of suture used for tying the graft to the loop is still evaluated and discussed...
2018: Clujul Medical (1957)
https://www.readbyqxmd.com/read/29413193/editorial-commentary-buckle-up-surgeons-safety-belt-reinforcement-of-knee-anterior-cruciate-ligament-reconstruction-grafts
#18
EDITORIAL
Asheesh Bedi
Safety belt, or cerclage, reinforcement of anterior cruciate ligament (ACL) grafts may protect against various modes of failure including creep and irreversible stretch, traumatic tearing, and slippage of the tendon-bone interface. A time-zero, biomechanical study shows that suture reinforcement may protect small and vulnerable hamstring ACL reconstruction grafts from these various modes of failure. Thus, in vivo comparative outcome analysis is indicated to determine if the benefits of reinforcement translate from the benchtop to the operating room...
February 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29408566/pull-out-strength-of-four-tibial-fixation-devices-used-in-anterior-cruciate-ligament-reconstruction
#19
M Chivot, S Harrosch, F Kelberine, M Pithioux, J-N Argenson, M Ollivier
INTRODUCTION: In reconstructions of the anterior cruciate ligament (ACL), tibial fixation can be the weak point in the assembly during the early postoperative period. The present study sought to compare pull-out strength between four tibial fixation systems used in ACL reconstruction. HYPOTHESIS: The study hypothesis was that all four devices show ≥450N pull-out strength with comparable biomechanical breakage characteristics. MATERIAL AND METHODS: An experimental study used a mechanical model to perform axial traction on a synthetic ligament (polypropylene cord folded in four) implanted in an artificial tibia (Sawbones Proximal Tibia # 1116-2: model: normal anatomy; solid foam; size: medium) using four tibial fixation systems: Ligafix® interference screw (SBM™); Bio-Intrafix® (Mitek™); Translig® (SBM™); RIGIDfix® (SBM™)...
April 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29379983/biomechanical-comparisons-of-current-suspensory-fixation-devices-for-anterior-cruciate-ligament-reconstruction
#20
Jin Cheng, Siddhartha Venkata Paluvadi, SungJae Lee, SeungJin Yoo, Eun-Kyoo Song, Jong-Keun Seon
PURPOSE: Cortical suspensory devices are routinely used for femoral side fixation of soft tissue graft in anterior cruciate ligament (ACL) reconstruction. The purpose of this study was to evaluate the biomechanical properties of a new adjustable loop device (GraftMax®) compared with established devices (EndoButton® and TightRope®) in ACL reconstruction and to investigate whether knotting the free end of TightRope could improve biomechanical properties. METHODS: The three cortical suspensory devices (GraftMax® Button; Conmed, EndoButton® CL; Smith & Nephew, and TightRope® RT; Arthrex) were tested under cyclic load (50-250 N for 1000 cycles) and pull-to-failure conditions at 50 mm/h in a device-only setup using a tensile testing machine...
January 29, 2018: International Orthopaedics
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