|
The Journal of Bone and Joint Surgery, Vol 70, Issue 7 1020-1031, Copyright © 1988 by Journal of Bone and Joint Surgery, Inc
Measurement of stability of the knee and ligament force after implantation of a synthetic anterior cruciate ligament. In vitro measurement
RC More and KL Markolf
Division of Orthopaedic Surgery, University of California, Los Angeles 90024-1795.
A Gore-Tex prosthetic ligament was inserted, with an over-the-top femoral
placement, into thirteen fresh-frozen cadaver knees as a substitute for the
anterior cruciate ligament. The femoral eyelet was screwed into bone and
the tibial eyelet was attached to a force-transducer, which was positioned
and locked on a tibial slider track to record forces in the ligament as the
tibia was externally loaded. A reference position was established for the
tibial eyelet so that, after the Gore-Tex ligament was implanted, the total
anterior-posterior laxity of the knee (at 200 newtons of applied tibial
force) matched that of the intact knee (that is, before the anterior
cruciate ligament had been cut) at 20 degrees of flexion. With both ends of
the ligament secured in the knee, repeated 200-newton anterior-posterior
load cycles produced an increase of five to seven millimeters in the total
laxity. This apparent stretch-out of the ligament could be worked out of
the knee by manually flexing and extending the knee thirty times between
zero and 90 degrees of flexion while a constant 200-newton force was
applied to the tibial eyelet. After implantation of the Gore-Tex ligament,
the laxity of the knee matched that of the intact specimen at 20 degrees of
flexion and matched it within one millimeter at zero, 5, and 10 degrees of
flexion. For each millimeter that the tibial eyelet was moved distally, the
total anterior-posterior laxity decreased by the same amount. The anterior
stiffness of the knee after implantation of the Gore-Tex ligament was
always less than that of the intact specimen. With an applied extension
moment of ten newton-meters, section of the anterior cruciate ligament
increased hyperextension of the knee by 2.3 degrees; implantation of the
Gore-Tex ligament did not restore full extension, even when the ligament
was over-tightened by using a distal location for the tibial eyelet. When
the eyelet was in the reference position, the ligament forces ranged from
three to 319 newtons when the knee was in full extension, they rose
dramatically as the knee was hyperextended, and they decreased to zero in
most specimens as the knee was flexed more than 15 degrees. The pull of the
quadriceps tendon against fixed resistance always increased the ligament
forces. The application of tibiofemoral contact force reduced the ligament
forces that were generated during a straight anterior tibial pull.(ABSTRACT
TRUNCATED AT 400 WORDS)
 CiteULike  Connotea  Del.icio.us  Technorati What's this?
This article has been cited by other articles:
|
|
|
|
 
A. Karchin, M.L. Hull, and S.M. Howell
Initial Tension and Anterior Load-Displacement Behavior of High-Stiffness Anterior Cruciate Ligament Graft Constructs
J. Bone Joint Surg. Am.,
August 1, 2004;
86(8):
1675 - 1683.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. W. Starch, J. W. Alexander, P. C. Noble, S. Reddy, and D. M. Lintner
Multistranded Hamstring Tendon Graft Fixation with a Central Four-Quadrant or a Standard Tibial Interference Screw for Anterior Cruciate Ligament Reconstruction
Am. J. Sports Med.,
May 1, 2003;
31(3):
338 - 344.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
W. E. Nordt III, P. Lotfi, E. Plotkin, and B. Williamson
The In Vivo Assessment of Tibial Motion in the Transverse Plane in Anterior Cruciate Ligament-Reconstructed Knees
Am. J. Sports Med.,
September 1, 1999;
27(5):
611 - 616.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. L. MARKOLF, D. M. BURCHFIELD, M. M. SHAPIRO, C. W. CHA, G. A. M. FINERMAN, and J. L. SLAUTERBECK
Biomechanical Consequences of Replacement of the Anterior Cruciate Ligament with a Patellar Ligament Allograft. Part II: Forces in the Graft Compared with Forces in the Intact Ligament
J. Bone Joint Surg. Am.,
November 1, 1996;
78(11):
1728 - 34.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
L. Durselen, L. Claes, and H. Kiefer
The Influence of Muscle Forces and External Loads on Cruciate Ligament Strain
Am. J. Sports Med.,
January 1, 1995;
23(1):
129 - 136.
[Abstract]
[PDF]
|
|
|
|
|
|
|
L. Good, M. Odensten, and J. Gillquist
Sagittal Knee Stability After Anterior Cruciate Ligament Reconstruction with a Patellar Tendon Strip: A Two-year Follow-up Study
Am. J. Sports Med.,
July 1, 1994;
22(4):
518 - 523.
[Abstract]
[PDF]
|
|
|
|
|
|
|
P. A. Torzilli, Xianghua Deng, and R. F. Warren
The Effect of Joint-Compressive Load and Quadriceps Muscle Force on Knee Motion in the Intact and Anterior Cruciate Ligament-Sectioned Knee
Am. J. Sports Med.,
January 1, 1994;
22(1):
105 - 112.
[Abstract]
[PDF]
|
|
|
|
|
|
|
B. K. Graf, J. Henry, M. Rothenberg, and R. Vanderby
Anterior Cruciate Ligament Reconstruction with Patellar Tendon: An Ex Vivo Study of Wear-related Damage and Failure at the Femoral Tunnel
Am. J. Sports Med.,
January 1, 1994;
22(1):
131 - 135.
[Abstract]
[PDF]
|
|
|
|
|
|
|
T. H. Gertel, W. D. Lew, J. L. Lewis, N. J. Stewart, and R. E. Hunter
Effect of anterior cruciate ligament graft tensioning direction, magnitude, and flexion angle on knee biomechanics
Am. J. Sports Med.,
July 1, 1993;
21(4):
572 - 581.
[Abstract]
[PDF]
|
|
|
|
|
|
|
G. S. Berns and S. M. Howell
Roofplasty requirements in vitro for different tibial hole placements in anterior cruciate ligament reconstruction
Am. J. Sports Med.,
March 1, 1993;
21(2):
292 - 298.
[Abstract]
[PDF]
|
|
|
|
|
|
|
R. S. Brower, A. Melby, M. J. Askew, and D. C. Beringer
In vitro comparison of over-the-top and through-the-condyle anterior cruciate ligament reconstructions
Am. J. Sports Med.,
September 1, 1992;
20(5):
567 - 574.
[Abstract]
[PDF]
|
|
|
|
|
|
|
L. E. Paulos, T. D. Rosenberg, S. R. Grewe, D. S. Tearse, and C. L. Beck
The GORE-TEX anterior cruciate ligament prosthesis: A long-term followup
Am. J. Sports Med.,
June 1, 1992;
20(3):
246 - 252.
[Abstract]
[PDF]
|
|
|
|
