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ACL reconstruction and biomechanics

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https://www.readbyqxmd.com/read/28816898/timing-of-postoperative-mechanical-loading-affects-healing-following-anterior-cruciate-ligament-reconstruction-analysis-in-a-murine-model
#1
Christopher L Camp, Amir Lebaschi, Guang-Ting Cong, Zoe Album, Camila Carballo, Xiang-Hua Deng, Scott A Rodeo
BACKGROUND: Following anterior cruciate ligament (ACL) reconstruction, the mechanical loading of the tissues has a significant impact on tendon-to-bone healing. The purpose of this study was to determine the effect of the timing of the initiation of mechanical loading on healing of a tendon graft in a bone tunnel. METHODS: ACL reconstruction using a flexor tendon autograft was performed in 56 mice randomized to 4 groups with differing times to initiation of postoperative mechanical loading: (1) immediate, (2) 5 days, (3) 10 days, or (4) 21 days following surgery...
August 16, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28809626/-structural-damage-to-the-hamstring-graft-due-to-interaction-with-fixation-material-and-its-effect-on-biomechanical-properties-of-acl-reconstruction
#2
J Kautzner, M Držík, M Handl, C Povýšil, P Kos, T Trč, V Havlas
PURPOSE OF THE STUDY Hamstring grafts are commonly used for ACL reconstruction. The purpose of our study is to determine the effects of the suspension fixation compared to graft cross-pinning transfixation, and the effect(s) of structural damage during the preparation of the graft on biomechanical properties of the graft. MATERIAL AND METHODS The design of the study is a cadaveric biomechanical laboratory study. 38 fresh-frozen human hamstring specimens from 19 cadaveric donors were used. The grafts were tested for their loading properties...
2017: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28800252/progressive-changes-in-walking-kinematics-and-kinetics-after-anterior-cruciate-ligament-injury-and-reconstruction-a-review-and-meta-analysis
#3
Lindsay V Slater, Joseph M Hart, Adam R Kelly, Christopher M Kuenze
CONTEXT:   Anterior cruciate ligament (ACL) injury and ACL reconstruction (ACLR) result in persistent alterations in lower extremity movement patterns. The progression of lower extremity biomechanics from the time of injury has not been described. OBJECTIVE:   To compare the 3-dimensional (3D) lower extremity kinematics and kinetics of walking among individuals with ACL deficiency (ACLD), individuals with ACLR, and healthy control participants from 3 to 64 months after ACLR...
August 11, 2017: Journal of Athletic Training
https://www.readbyqxmd.com/read/28721590/high-non-anatomic-tunnel-position-rates-in-acl-reconstruction-failure-using-both-transtibial-and-anteromedial-tunnel-drilling-techniques
#4
Vera Jaecker, Tabea Zapf, Jan-Hendrik Naendrup, Thomas Pfeiffer, Ajay C Kanakamedala, Arasch Wafaisade, Sven Shafizadeh
INTRODUCTION: Although it is well known from cadaveric and biomechanical studies that transtibial femoral tunnel (TT) positioning techniques are associated with non-anatomic tunnel positions, controversial data exist as so far no clinical differences could have been found, comparing transtibial with anteromedial techniques (AM). The purpose of the study was to analyze if graft failure following TT ACL reconstruction was more commonly associated with non-anatomic tunnel position in comparison with the AM technique...
July 18, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28712025/side-to-side-asymmetries-in-landing-mechanics-from-a-drop-vertical-jump-test-are-not-related-to-asymmetries-in-knee-joint-laxity-following-anterior-cruciate-ligament-reconstruction
#5
Christophe A G Meyer, Paul Gette, Caroline Mouton, Romain Seil, Daniel Theisen
PURPOSE: Asymmetries in knee joint biomechanics and increased knee joint laxity in patients following anterior cruciate ligament reconstruction (ACLR) are considered risk factors for re-tear or early onset of osteoarthritis. Nevertheless, the relationship between these factors has not been established. The aim of the study was to compare knee mechanics during landing from a bilateral drop vertical jump in patients following ACLR and control participants and to study the relationship between side-to-side asymmetries in landing mechanics and knee joint laxity...
July 15, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28706801/combined-anatomic-reconstruction-of-the-anterior-cruciate-and-anterolateral-ligaments-using-hamstring-graft-through-a-single-femoral-tunnel-and-with-a-single-femoral-fixation
#6
Assem Mohamed Noureldin Zein, Mohamed Ali, Hesham Ali, Ahmed Nady Saleh Elsaid, Alaa Zenhom Mahmoud, Mohamed K Osman, Amr Mohamed Mohamed Soliman
Patients with complete anterior cruciate ligament (ACL) injury have different degrees of rotational (internal rotation) laxity. A residual pivot shift has been found to be positive in more than 15% of cases after an accurate ACL reconstruction. Improved understanding of the existence, function, and biomechanical role of the anterolateral ligament (ALL) in controlling rotational instability of the knee has redirected and refocused attention on a supplemental extra-articular reconstruction of the ALL in conjunction with the intra-articular ACL reconstruction so as to restore normal kinematics of the knee...
June 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28706794/notchplasty-for-the-arthroscopic-treatment-of-limited-knee-extension
#7
Marcio B Ferrari, Sandeep Mannava, Nicholas DePhillipo, George Sanchez, Robert F LaPrade
Knee osteoarthritis may lead to narrowing of the intercondylar notch due to osteophyte formation, thereby causing changes in native knee biomechanics. The normal close contact between the condyles and the anterior cruciate ligament (ACL) during knee extension may be compromised due to narrowing of the notch and result in ACL damage, progression of knee osteoarthritis, and loss of knee extension. Outcomes after a notchplasty procedure are well reported for ACL reconstruction in young patients. However, there remains a lack of studies evaluating this procedure in the setting of knee osteoarthritis in patients with a symptomatic loss of knee extension...
June 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28683233/development-of-a-clinician-rated-drop-vertical-jump-scale-for-patients-undergoing-rehabilitation-after-anterior-cruciate-ligament-reconstruction-a-delphi-approach
#8
Sheila S Gagnon, Trevor B Birmingham, Bert M Chesworth, Dianne Bryant, Melanie Werstine, J Robert Giffin
Study Design Delphi panel study. Background Biomechanical parameters measured during a drop vertical jump task are risk factors for anterior cruciate ligament (ACL) injury and are targeted during rehabilitation after ACL reconstruction. A clinically feasible tool that quantifies observed performance on the drop vertical jump would help inform treatment efforts. The content and scoring of such a tool should be deliberated on by a group of experts throughout its development. Objectives To establish consensus on the content and scoring of a clinician-rated drop vertical jump scale (DVJS) for use during rehabilitation after ACL reconstruction...
August 2017: Journal of Orthopaedic and Sports Physical Therapy
https://www.readbyqxmd.com/read/28680900/semitendinosus-tendon-for-acl-reconstruction-regrowth-and-mechanical-property-recovery
#9
Stephen M Suydam, Daniel H Cortes, Michael J Axe, Lynn Snyder-Mackler, Thomas S Buchanan
BACKGROUND: Semitendinosus/gracilis (STG) tendon autograft has been used effectively for restoring knee stability after anterior cruciate ligament (ACL) rupture. Though ACL reconstruction with STG autograft is an effective surgical technique for return to sports, short-term hamstring strength asymmetries exist after surgery. Although imaging evidence has demonstrated regrowth and reorganization of the semitendinosus (ST) tendon, no studies show whether the regrowth is associated with residual muscle function...
June 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28680890/phase-specific-ground-reaction-force-analyses-of-bilateral-and-unilateral-jumps-in-patients-with-acl-reconstruction
#10
Christian Baumgart, Matthias W Hoppe, Jürgen Freiwald
BACKGROUND: In patients who have undergone anterior cruciate ligament (ACL) reconstruction, there is a weak correlation between subjective evaluation of knee function on questionnaires and clinical or biomechanical test results. HYPOTHESIS: Patients with lower subjective knee function will demonstrate lower ground-reaction forces (GRFs) in the operated leg and greater GRF asymmetries in both phase-specific and functional data analysis (FDA) approaches compared with patients with higher subjective knee function...
June 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28680888/early-graft-tunnel-healing-after-anterior-cruciate-ligament-reconstruction-with-intratunnel-injection-of-bone-marrow-mesenchymal-stem-cells-and-vascular-endothelial-growth-factor
#11
Rosy Setiawati, Dwikora Novembri Utomo, Fedik Abdul Rantam, Nadia Nastassia Ifran, Nicolaas C Budhiparama
BACKGROUND: Bone marrow mesenchymal stem cells (BM-MSCs) are multipotent adult stem cells and have become an important source of cells for engineering tissue repair and cell therapy. Vascular endothelial growth factor (VEGF) promotes angiogenesis and contributes fibrous integration between tendon and bone during the early postoperative stage. Both MSCs and VEGF can stimulate cell proliferation, differentiation, and matrix deposition by enhancing angiogenesis and osteogenesis of the graft in the tunnel...
June 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28667211/criteria-for-return-to-sport-after-anterior-cruciate-ligament-reconstruction-with-lower-reinjury-risk-cr-stal-study-protocol-for-a-prospective-observational-study-in-france
#12
Alexandre J M Rambaud, Bertrand Semay, Pierre Samozino, Jean-Benoît Morin, Rodolphe Testa, Rémi Philippot, Jérémy Rossi, Pascal Edouard
INTRODUCTION: The decision regarding when to return to sport after an anterior cruciate ligament reconstruction (ACLR) is an important one. Using a variety of subjective and objective parameters, various attempts have been made to determine an optimal timeline for a return to sport after ACLR, but none have been validated.The aim of the present study is therefore to determine which criteria or combination of criteria could allow to return to sport with the lowest possible risk of reinjury...
June 30, 2017: BMJ Open
https://www.readbyqxmd.com/read/28660229/lateral-meniscus-posterior-root-and-meniscofemoral-ligaments-as-stabilizing-structures-in-the-acl-deficient-knee-a-biomechanical-study
#13
Jonathan M Frank, Gilbert Moatshe, Alex W Brady, Grant J Dornan, Ashley Coggins, Kyle J Muckenhirn, Erik L Slette, Jacob D Mikula, Robert F LaPrade
BACKGROUND: The biomechanical effects of lateral meniscal posterior root tears with and without meniscofemoral ligament (MFL) tears in anterior cruciate ligament (ACL)-deficient knees have not been studied in detail. PURPOSE: To determine the biomechanical effects of the lateral meniscus (LM) posterior root tear in ACL-intact and ACL-deficient knees. In addition, the biomechanical effects of disrupting the MFLs in ACL-deficient knees with meniscal root tears were evaluated...
June 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28646383/anterior-cruciate-ligament-graft-fixation-first-in-anterior-and-posterior-cruciate-ligament-reconstruction-best-restores-knee-kinematics
#14
Libin Zheng, Soheil Sabzevari, Brandon Marshall, Junjun Zhu, Monica A Linde, Patrick Smolinski, Freddie H Fu
PURPOSE: To evaluate the effect of different graft fixation sequences in one-stage anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) reconstruction on (1) knee biomechanics and (2) tibiofemoral alignment. METHODS: Twelve porcine knees were used in this study. Five fixation sequences were performed (angle indicating knee flexion): (a) PCL at 30° and ACL at 30°, (b) PCL at 90° and ACL at 30°, (c) ACL at 30° and PCL at 30°, (d) ACL at 30° and PCL at 90°, and (e) ACL and PCL simultaneous fixation at 30°...
June 23, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28631112/risk-of-revision-was-not-reduced-by-a-double-bundle-acl-reconstruction-technique-results-from-the-scandinavian-registers
#15
Cathrine Aga, Jüri-Tomas Kartus, Martin Lind, Stein Håkon Låstad Lygre, Lars-Petter Granan, Lars Engebretsen
BACKGROUND: Double-bundle anterior cruciate ligament (ACL) reconstruction has demonstrated improved biomechanical properties and moderately better objective outcomes compared with single-bundle reconstructions. This could make an impact on the rerupture rate and reduce the risk of revisions in patients undergoing double-bundle ACL reconstruction compared with patients reconstructed with a traditional single-bundle technique. The National Knee Ligament Registers in Scandinavia provide information that can be used to evaluate the revision outcome after ACL reconstructions...
June 19, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28602934/biomechanical-factors-associated-with-pain-and-symptoms-following-anterior-cruciate-ligament-injury-and-reconstruction
#16
Aisia Azus, Hsiang-Ling Teng, Lauren Tufts, Daniel Wu, C Benjamin Ma, Richard B Souza, Xiaojuan Li
BACKGROUND: Few studies have investigated the associations between patient-reported outcome and gait in patients with anterior cruciate ligament (ACL) injury and reconstruction over time. Because there is an association between ACL rupture and the presence of osteoarthritis later in life, a better understanding of these relationships will help to elucidate how patients' gait pattern may affect pain and symptoms, potentially leading to better treatment for or preventing the development of knee OA...
June 8, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28577573/differences-in-placement-of-calcium-phosphate-hybridized-tendon-grafts-within-the-femoral-bone-tunnel-during-acl-reconstruction-do-not-influence-tendon-to-bone-healing
#17
Hirotaka Mutsuzaki, Hiromi Nakajima, Shunsuke Nomura, Masataka Sakane
BACKGROUND: Calcium phosphate (CaP)-hybridization of tendon grafts has been shown to improve tendon-to-bone healing. The purpose of this study was to clarify the influence of different tendon graft placement methods on tendon-to-bone healing using CaP-hybridized tendon grafts in anterior cruciate ligament (ACL) reconstructions in rabbits. METHODS: We compared two methods of tendon graft placement within the femoral bone tunnel: suspension of the tendon graft within the bone tunnel (suspension group) and implantation of the tendon graft coherent with the bone socket (coherence group)...
June 2, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28568474/the-biomechanical-effect-of-tunnel-placement-on-acl-graft-forces-in-double-bundle-acl-reconstruction-a-3d-computational-simulation
#18
Nathan H Varady, Willem A Kernkamp, Jingsheng Li, Lianxin Wang, Hiroshi Koga, Peter Asnis, Guoan Li
BACKGROUND: The posterolateral (PL) graft experiences a high failure rate in anterior cruciate ligament double-bundle (DB) reconstruction. It is hypothesized that tunnel positions could dramatically affect the graft forces. METHODS: A validated computational model was used to simulate DB reconstruction with various femoral PL tunnel locations (8-11 mm center-center tunnel spacing). Graft fixation was simulated at both 0° and 30°. Knee biomechanics were examined with the knee under a 134 N anterior load and 400 N quadriceps load at 0°, 30°, 60°, and 90° of flexion...
June 1, 2017: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
https://www.readbyqxmd.com/read/28567428/acl-roof-impingement-revisited-does-the-independent-femoral-drilling-technique-avoid-roof-impingement-with-anteriorly-placed-tibial-tunnels
#19
John A Tanksley, Brian C Werner, Evan J Conte, David P Lustenberger, M Tyrrell Burrus, Stephen F Brockmeier, F Winston Gwathmey, Mark D Miller
BACKGROUND: Anatomic femoral tunnel placement for single-bundle anterior cruciate ligament (ACL) reconstruction is now well accepted. The ideal location for the tibial tunnel has not been studied extensively, although some biomechanical and clinical studies suggest that placement of the tibial tunnel in the anterior part of the ACL tibial attachment site may be desirable. However, the concern for intercondylar roof impingement has tempered enthusiasm for anterior tibial tunnel placement...
May 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28559102/biomechanical-characteristics-of-the-anatomic-rectangular-tunnel-anterior-cruciate-ligament-reconstruction-with-a-bone-patellar-tendon-bone-graft
#20
Tatsuo Mae, Konsei Shino, Ryo Iuchi, Kazutaka Kinugasa, Ryohei Uchida, Shigeto Nakagawa, Hideki Yoshikawa, Ken Nakata
PURPOSE: To clarify 1) the force sharing between two portions of BTB graft in anatomic rectangular tunnel (ART) reconstruction and 2) the knee stability in ART technique under anterior tibial load. METHODS: Eleven fresh cadaveric knees were used. First, anterior-posterior (A-P) laxity was measured with Knee Laxity Tester(®) in response to 134 N of A-P tibial load at 20° on the normal knees. Then ART ACL reconstruction was performed with a BTB graft. For graft, the patellar bone plug and tendon portion was longitudinally cut into half as AM and PL portions...
May 27, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
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