View in EDS

Influence of anterior cruciate ligament bundles on knee kinematics: clinical assessment using computer-assisted navigation.

Saved in:
Bibliographic Details
Title: Influence of anterior cruciate ligament bundles on knee kinematics: clinical assessment using computer-assisted navigation.
Authors: Robinson J (AUTHOR), Carrat L (AUTHOR), Granchi C (AUTHOR), Colombet P (AUTHOR)
Source: American Journal of Sports Medicine. Dec2007, Vol. 35 Issue 12, p2006-2013. 8p.
Abstract: BACKGROUND: The synergistic functions of the anteromedial and posterolateral bundles of the anterior cruciate ligament in restraining anterior laxity are known. Cadaveric experiments have also suggested different functions of the 2 bundles in controlling a combined rotatory load simulating the pivot shift. HYPOTHESIS: The posterolateral bundle is important in controlling the coupled tibial axial rotation laxity occurring during clinical laxity tests performed in vivo, particularly the pivot-shift maneuver. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: Twenty-one patients underwent navigated 2-bundle anterior cruciate ligament reconstruction. The navigation was additionally used to measure the knee kinematics in response to the anterior drawer test (performed at 90 degrees ), Lachman test (performed at 20 degrees of flexion), and pivot-shift test. Two sequential reconstruction protocols were used to assess the contribution of the anteromedial and posterolateral bundles to restraining tibial translations and coupled axial rotation occurring with the manually performed clinical laxity tests. RESULTS: Anterior tibial translation during the anterior drawer test was better restrained by anteromedial bundle reconstruction than by posterolateral bundle reconstruction. Conversely, posterolateral bundle reconstruction better restrained anterior tibial translation during the Lachman test. Both bundles contributed to the control of anterior laxity during the pivot shift. However, the posterolateral bundle was more important than was the anteromedial bundle in controlling the tibial rotational component (posterolateral bundle reconstruction caused a 53% reduction in tibial rotation laxity compared with a 42% reduction with anteromedial bundle reconstruction, P< .0001). CONCLUSION: This study provides objective, in vivo data about how the anteromedial and posterolateral bundles act differentially to stabilize the knee, particularly during the pivot shift. The posterolateral bundle was important in controlling not only anterior laxity toward knee extension but the rotational component of the pivot shift. [ABSTRACT FROM AUTHOR]
Copyright of American Journal of Sports Medicine is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Education Research Complete
Description
Abstract:BACKGROUND: The synergistic functions of the anteromedial and posterolateral bundles of the anterior cruciate ligament in restraining anterior laxity are known. Cadaveric experiments have also suggested different functions of the 2 bundles in controlling a combined rotatory load simulating the pivot shift. HYPOTHESIS: The posterolateral bundle is important in controlling the coupled tibial axial rotation laxity occurring during clinical laxity tests performed in vivo, particularly the pivot-shift maneuver. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: Twenty-one patients underwent navigated 2-bundle anterior cruciate ligament reconstruction. The navigation was additionally used to measure the knee kinematics in response to the anterior drawer test (performed at 90 degrees ), Lachman test (performed at 20 degrees of flexion), and pivot-shift test. Two sequential reconstruction protocols were used to assess the contribution of the anteromedial and posterolateral bundles to restraining tibial translations and coupled axial rotation occurring with the manually performed clinical laxity tests. RESULTS: Anterior tibial translation during the anterior drawer test was better restrained by anteromedial bundle reconstruction than by posterolateral bundle reconstruction. Conversely, posterolateral bundle reconstruction better restrained anterior tibial translation during the Lachman test. Both bundles contributed to the control of anterior laxity during the pivot shift. However, the posterolateral bundle was more important than was the anteromedial bundle in controlling the tibial rotational component (posterolateral bundle reconstruction caused a 53% reduction in tibial rotation laxity compared with a 42% reduction with anteromedial bundle reconstruction, P< .0001). CONCLUSION: This study provides objective, in vivo data about how the anteromedial and posterolateral bundles act differentially to stabilize the knee, particularly during the pivot shift. The posterolateral bundle was important in controlling not only anterior laxity toward knee extension but the rotational component of the pivot shift. [ABSTRACT FROM AUTHOR]
ISSN:03635465
DOI:10.1177/0363546507308547