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In vivo kinematics of the knee after anterior cruciate ligament reconstruction: a clinical and functional evaluation.

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Title: In vivo kinematics of the knee after anterior cruciate ligament reconstruction: a clinical and functional evaluation.
Authors: Papannagari R (AUTHOR), Gill TJ (AUTHOR), DeFrate LE (AUTHOR), Moses JM (AUTHOR), Petruska AJ (AUTHOR), Li G (AUTHOR)
Source: American Journal of Sports Medicine. Dec2006, Vol. 34 Issue 12, p2006-2012. 7p.
Abstract: BACKGROUND: Recent follow-up studies have reported a high incidence of joint degeneration in patients with anterior cruciate ligament reconstruction. Abnormal kinematics after anterior cruciate ligament reconstruction have been thought to contribute to the degeneration. HYPOTHESIS: Anterior cruciate ligament reconstruction, which was designed to restore anterior knee laxity under anterior tibial loads, does not reproduce knee kinematics under in vivo physiological loading conditions. STUDY DESIGN: Controlled laboratory study. METHODS: Both knees of 7 patients with complete unilateral rupture of the anterior cruciate ligament were magnetic resonance imaged, and 3D models were constructed from these images. The anterior cruciate ligament of the injured knee was arthroscopically reconstructed using a bone-patellar tendon-bone autograft. Three months after surgery, the kinematics of the intact contralateral and reconstructed knees were measured using a dual-orthogonal fluoroscopic system while the subjects performed a single-legged weightbearing lunge. The anterior laxity of both knees was measured using a KT-1000 arthrometer. RESULTS: The anterior laxity of the reconstructed knee as measured with the arthrometer was similar to that of the intact contralateral knee. However, under weightbearing conditions, there was a statistically significant increase in anterior translation of the reconstructed knee compared with the intact knee at full extension (approximately 2.9 mm) and 15 degrees (approximately 2.2 mm) of flexion. In addition, there was a mean increase in external tibial rotation of the anterior cruciate ligament-reconstructed knee beyond 30 degrees of flexion (approximately 2 degrees at 30 degrees of flexion), although no statistical significance was detected. CONCLUSION: The data demonstrate that although anterior laxity was restored during KT-1000 arthrometer testing, anterior cruciate ligament reconstruction did not restore normal knee kinematics under weightbearing loading conditions. CLINICAL RELEVANCE: Future reconstruction techniques should aim to restore function of the knee under physiological loading conditions. [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
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  Data: In vivo kinematics of the knee after anterior cruciate ligament reconstruction: a clinical and functional evaluation.
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  Data: <searchLink fieldCode="AR" term="%22Papannagari+R%22">Papannagari R</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Gill+TJ%22">Gill TJ</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22DeFrate+LE%22">DeFrate LE</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Moses+JM%22">Moses JM</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Petruska+AJ%22">Petruska AJ</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Li+G%22">Li G</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22American+Journal+of+Sports+Medicine%22">American Journal of Sports Medicine</searchLink>. Dec2006, Vol. 34 Issue 12, p2006-2012. 7p.
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: BACKGROUND: Recent follow-up studies have reported a high incidence of joint degeneration in patients with anterior cruciate ligament reconstruction. Abnormal kinematics after anterior cruciate ligament reconstruction have been thought to contribute to the degeneration. HYPOTHESIS: Anterior cruciate ligament reconstruction, which was designed to restore anterior knee laxity under anterior tibial loads, does not reproduce knee kinematics under in vivo physiological loading conditions. STUDY DESIGN: Controlled laboratory study. METHODS: Both knees of 7 patients with complete unilateral rupture of the anterior cruciate ligament were magnetic resonance imaged, and 3D models were constructed from these images. The anterior cruciate ligament of the injured knee was arthroscopically reconstructed using a bone-patellar tendon-bone autograft. Three months after surgery, the kinematics of the intact contralateral and reconstructed knees were measured using a dual-orthogonal fluoroscopic system while the subjects performed a single-legged weightbearing lunge. The anterior laxity of both knees was measured using a KT-1000 arthrometer. RESULTS: The anterior laxity of the reconstructed knee as measured with the arthrometer was similar to that of the intact contralateral knee. However, under weightbearing conditions, there was a statistically significant increase in anterior translation of the reconstructed knee compared with the intact knee at full extension (approximately 2.9 mm) and 15 degrees (approximately 2.2 mm) of flexion. In addition, there was a mean increase in external tibial rotation of the anterior cruciate ligament-reconstructed knee beyond 30 degrees of flexion (approximately 2 degrees at 30 degrees of flexion), although no statistical significance was detected. CONCLUSION: The data demonstrate that although anterior laxity was restored during KT-1000 arthrometer testing, anterior cruciate ligament reconstruction did not restore normal knee kinematics under weightbearing loading conditions. CLINICAL RELEVANCE: Future reconstruction techniques should aim to restore function of the knee under physiological loading conditions. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>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.</i> (Copyright applies to all Abstracts.)
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              Text: Dec2006
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