Article

Reconstruction of the anterior cruciate ligament is a standard
surgical procedure in sports traumatology. The widespread replacement method
using hamstring tendons has an important shortcoming namely delayed or missing
bony healing in contrast to patellar tendon grafts where implant-free fixation is
established by using the adjacent bone blocks. The purpose of this study was to
describe a new implant-free surgical procedure using hamstring tendon grafts and
to analyse the influence on tibiofemoral kinematics in vitro. METHODS: Nine human
knee specimens with arthroscopically transected anterior cruciate ligaments were
mounted on a dynamic knee simulator and weight-bearing muscle-loaded knee
flexions were simulated while a robotic universal force sensor system was used to
provide external tibial loads. Three different loading conditions were simulated
including partial body weight only, an additional 50 N anterior tibial force or
an additional Five Nm of internal rotational torque. After reconstruction of the
anterior cruciate ligament using a tibial bone block hybrid technique these three
trials were repeated. The kinematics was measured with an ultrasonic measuring
system and different loading and ligament conditions were examined. Graft tunnel
placement was verified by computed tomography. FINDINGS: Our fixation method
achieved stability to anterior tibial drawer force whereas internal tibial
rotation did not change before and after the reconstruction. Computed tomography
confirmed anatomical graft and tunnel placement. INTERPRETATION: The presented
operative procedure is technically feasible and leads to reproducible results
concerning knee joint kinematics and graft placement.
CI - Copyright (c) 2011 Elsevier Ltd. All rights reserved.

Langue : ANGLAIS