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Analysis of the graft bending angle at the femoral tunnel aperture in anatomic double bundle anterior cruciate ligament reconstruction: a comparison of the transtibial and the far anteromedial portal technique

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

The aim of this study is to investigate and compare the three dimensional bending angle of the graft at the femoral tunnel aperture in the transtibial and the far anteromedial portal technique. Seven fresh-frozen human cadaveric knees were used. Six degrees-of-freedom of knee kinematics and knee position data were measured using an electromagnetic device and the three dimensional bending angles of the each graft at the femoral tunnel aperture were calculated by computer simulation. Additionally, in order to assess the stress on the graft, the length change between the femoral and tibial attachment sites of the AM and PL bundle were calculated. The maximum length of each bundle was detected at full extension of the knee. The relative change of the length of the PL bundle in the range of 70°–0° of knee flexion was significantly larger than that of the AM bundle. (P < 0.05) Maximum graft bending angles in both techniques were obtained at full extension where the graft was fully stretched. The AM and PL graft bending angles in the transtibial technique were significantly larger than in the far anteromedial portal technique at low flexion angle (AM: 0°–10°, PL: 0°–50°) (P < 0.01). This suggests use of the far anteromedial portal technique might result in lower stress on the graft at the femoral tunnel aperture and therefore might reduce graft damage.

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Acknowledgments

The authors would like to thank Zimmer Inc. (Japan) for their great support. We also acknowledge Mrs. Janina Tubby for her assistance in preparation of this manuscript.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Graduate School of Medicine, Kobe University, 7-5-1 Kusunoki-Cho, Chuo-Ku, Kobe, Hyogo, 650-0017, Japan

    Koji Nishimoto, Ryosuke Kuroda, Kiyonori Mizuno, Yuichi Hoshino, Seiji Kubo & Masahiro Kurosaka

  2. Department of Human and AI Systems, Faculty of Engineering, Fukui University, Fukui, Japan

    Kouki Nagamune

  3. Department of Orthopaedic Surgery, Hyogo College of Medicine, Nishinomiya, Japan

    Masayoshi Yagi & Shinichi Yoshiya

  4. Department of Orthopaedic Surgery, Meiwa Hospital, Nishinomiya, Hyogo, Japan

    Motoi Yamaguchi

Authors
  1. Koji Nishimoto
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  2. Ryosuke Kuroda
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  3. Kiyonori Mizuno
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  4. Yuichi Hoshino
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  5. Kouki Nagamune
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  7. Masayoshi Yagi
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  9. Shinichi Yoshiya
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  10. Masahiro Kurosaka
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Correspondence to Ryosuke Kuroda.

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Nishimoto, K., Kuroda, R., Mizuno, K. et al. Analysis of the graft bending angle at the femoral tunnel aperture in anatomic double bundle anterior cruciate ligament reconstruction: a comparison of the transtibial and the far anteromedial portal technique. Knee Surg Sports Traumatol Arthrosc 17, 270–276 (2009). https://doi.org/10.1007/s00167-008-0680-1

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  • DOI: https://doi.org/10.1007/s00167-008-0680-1

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