Document Detail

Can joint contact dynamics be restored by anterior cruciate ligament reconstruction?
MedLine Citation:
PMID:  23283673     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Rotational kinematics has become an important consideration after ACL reconstruction because of its possible influence on knee degeneration. However, it remains unknown whether ACL reconstruction can restore both rotational kinematics and normal joint contact patterns, especially during functional activities.
QUESTIONS/PURPOSES: We asked whether knee kinematics (tibial anterior translation and axial rotation) and joint contact mechanics (tibiofemoral sliding distance) would be restored by double-bundle (DB) or single-bundle (SB) reconstruction.
METHODS: We retrospectively studied 17 patients who underwent ACL reconstruction by the SB (n = 7) or DB (n = 10) procedure. We used dynamic stereo x-ray to capture biplane radiographic images of the knee during downhill treadmill running. Tibial anterior translation, axial rotation, and joint sliding distance in the medial and lateral compartments were compared between reconstructed and contralateral knees in both SB and DB groups.
RESULTS: We observed reduced anterior tibial translation and increased knee rotation in the reconstructed knees compared to the contralateral knees in both SB and DB groups. The mean joint sliding distance on the medial compartment was larger in the reconstructed knees than in the contralateral knees for both the SB group (9.5 ± 3.9 mm versus 7.5 ± 4.3 mm) and the DB group (11.1 ± 1.3 mm versus 7.9 ± 3.8 mm).
CONCLUSIONS: Neither ACL reconstruction procedure restored normal knee kinematics or medial joint sliding.
CLINICAL RELEVANCE: Further study is necessary to understand the clinical significance of abnormal joint contact, identify the responsible mechanisms, and optimize reconstruction procedures for restoring normal joint mechanics after ACL injury.
Yuichi Hoshino; Freddie H Fu; James J Irrgang; Scott Tashman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  471     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2013 Sep 
Date Detail:
Created Date:  2013-08-06     Completed Date:  2013-10-29     Revised Date:  2014-09-02    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2924-31     Citation Subset:  AIM; IM    
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MeSH Terms
Anterior Cruciate Ligament / injuries,  physiopathology,  surgery
Anterior Cruciate Ligament Reconstruction*
Biomechanical Phenomena / physiology
Knee / physiopathology,  surgery*
Knee Injuries / physiopathology,  surgery*
Knee Joint / physiopathology,  surgery*
Middle Aged
Range of Motion, Articular / physiology*
Reconstructive Surgical Procedures / methods
Retrospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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