Document Detail

Biomechanical function of anterior cruciate ligament remnants: how long do they contribute to knee stability after injury in patients with complete tears?
MedLine Citation:
PMID:  20888171     Owner:  NLM     Status:  In-Data-Review    
PURPOSE: This study aimed to evaluate the biomechanical function of anterior cruciate ligament (ACL) remnants in anteroposterior and rotational knee stability in patients with a complete ACL injury.
METHODS: ACL remnants were classified into 5 morphologic patterns: group 1, bridging between the posterior cruciate ligament and tibia; group 2, bridging between the intercondylar notch and tibia; group 3, partial rupture of the posterolateral bundle; group 4, partial rupture of the anteromedial bundle; and group 5, no substantial ACL remnants. The decision of whether the remaining bundle represented partial or complete rupture of the ACL was made based on physical, magnetic resonance imaging, and arthroscopic findings in a comprehensive manner. Patients in groups 1 (n = 18) and 2 (n = 12) underwent intraoperative arthrometry with a navigation system before and immediately after resection of the ACL remnant. The effects of chronicity (duration between injury and surgery) and ACL remnant pattern on changes in knee laxity after debridement of the ACL remnant were investigated.
RESULTS: Chronicity had a significant effect on changes in anteroposterior knee laxity evaluated at 30° of knee flexion after resection of the ACL remnant (change in laxity of 2.22 mm for chronicity ≤1 year and 0.17 mm for chronicity >1 year). Chronicity did not influence changes in rotational knee stability after resection of the remnant. There were no significant differences between groups 1 and 2 with regard to any of the evaluated changes in knee stability.
CONCLUSIONS: In groups 1 and 2 ACL remnants contributed to anteroposterior knee stability evaluated at 30° of knee flexion for up to 1 year after injury, beyond which this biomechanical function was lost. Chronicity and remnant pattern did not influence changes in rotational knee stability after resection of the remnant.
LEVEL OF EVIDENCE: Level III, diagnostic study of nonconsecutive patients.
Atsuo Nakamae; Mitsuo Ochi; Masataka Deie; Nobuo Adachi; Atsushi Kanaya; Makoto Nishimori; Tomoyuki Nakasa
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association     Volume:  26     ISSN:  1526-3231     ISO Abbreviation:  Arthroscopy     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8506498     Medline TA:  Arthroscopy     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1577-85     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
Department of Orthopaedic Surgery, Graduate School of Biomedical Science, Hiroshima University, Hiroshima, Japan.
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