Abstract
Unilateral weight bearing was simulated on 12 cadaver knees to quantitate anterior tibial translation (ATT) after anterior cruciate ligament (ACL) transection and to asses the role of the posteromedial structure and the hamstrings in controlling laxity. With the ACL intact, ATT was 3.5±2.8 mm in extension and 4.3±3.6 mm at 60° flexion. After sectioning the ACL, ATT was 6.5±4.7 mm in extension and 17.5±10 mm at 60° flexion (P=0.001). Applying a force in the hamstrings was unable to correct the pathological ATT observed after ACL section. Partial medial meniscectomy did not increase ATT after the ACL section. Disinsertion of the posterior horn of the medial meniscus and total medial meniscectomy increased ATT significantly compared to isolated ACL section. After ACL transection, sectioning the meniscotibial fibers or posteromedial capsule significantly increased ATT (6.5±0.5 mm in extension). Section of the postero-oblique ligament or popliteus tendon had no effect on ATT.
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Andriacchi TP (1990) Dynamics of pathological motion: applied to the anteriorcruciate deficient knee. J Biomech 23 [Suppl 1]:99–105
Bonnin M (1990) La subluxation tibiale antérieure en appui monopodal dans les ruptures du ligament croisé antérieur. Etude clinique et biomécanique. Thesis Med Lyon 180:47–68
Daniel DM, Stone ML (1988) Diagnosis of knee ligament injury: tests and measurements of joint laxity. In: Feagin JA (ed) The crucial ligaments. Churchill Livingstone
Daniel DM, Malcolm LL, Losse G, Stone ML, Sachs R, Burks R (1985) Instrumented measurements of anterior laxity of the knee. J Bone Joint Surg [Am] 67:720–726
Dejour H, Walch G, Deschamps G, Chambat P (1987) Arthrose du genou sur laxité chronique antérieure. Rev Chir Orthop 73:157–170
Dejour H, Walch G, Chambat P, Ranger P (1988) Active subluxation in extension: a new concept of study of the ACL deficient knee. Am J Knee Surg 1:204–211
Dejour H, Walch G, Neyret P, Adeleine P (1988) Résultat des laxités chroniques antérieures opérées: à propos de 251 cas revus avec un recul minimum de 3 ans. Rev Chir Orthop 74:622–636
Dejour H, Neyret P, Eberhard P, Walch G (1996) Absence congénitale bilatérale du ligament croisé antérieur et du ménisque interne. A propos d'un cas. Rev Chir Orthop (in press)
Van Eijden TMG, Deboer W, Weijs WA (1985) The orientation of the distal part of the quadriceps femoris muscle as a function of the knee flexion—extension angle. J Biomech 18:803–809
Fukubayashi T, Torzilli PA, Sherman MF, Warren RF (1982) An in vitro biomechanical evaluation of anterior posterior motion of the knee. J Bone Joint Surg [Am] 64:258–264
Gerber C, Hoppeler H, Claassen H, Robotti G, Zehnder R, Jakob R (1985) The lower—extremity musculature in chronic symptomatic instability of the anterior cruciate ligament. J Bone Joint Surg [Am] 67:1034–1043
Giove TP, Miller SJ, Kent BE, Sanford TL, Garrick JG (1983) Non operative treatment of the torn anterior cruciate ligament. J Bone Joint Surg [Am] 67:1029–1033
Gollehon DL, Torzilli PA, Warren RF (1987) The role of the postero lateral and cruciate ligaments in the stability of the human knee: a biomechanical study. J Bone Joint Surg [Am] 69:233–242
Grood ES, Noyes FR, Butler DL, Suntay WJ (1981) Ligamentous and capsular restraints preventing straight medial and lateral laxity in intact human cadaver knees. J Bone Joint Surg [Am] 63:1257–1269
Grood ES, Suntay WJ, Noyes FR, Butler DL (1984) Biomechanics of the knee extension exercise: effect of cutting the anterior cruciate ligament. J Bone Joint Surg [Am] 66:725–733
Henning CE, Lynch MA, Glick KR (1985) An in vivo strain gage study of elongation of the anterior cruciate ligament. Am J Sports Med 13:22–26
Hungerford DS, Barry M (1979) Biomechanics of the patellofemoral joint. Clin Orthop 144:9–15
Hsieh HH, Walkers PS (1976) Stabilizing mechanisms of the loaded and unloaded knee joint. J Bone Joint Surg [Am] 58:87–93
Jurist KA, Otis JC (1985) Anteroposterior tibiofemoral displacements during isometric extension efforts. The role of external load and knee flexion angle. Am J Sports Med 13:254–258
Kalund S, Sinkjaer T, Arendt-Nielsen L, Simonsen O (1990) Altered timing of hamstring muscle action in anterior cruciate ligament deficient patients. Am J Sports Med 18:245–248
Karrholm J, Selvik G, Elmquist LG, Hansson LI, Jonsson H (1988) Three dimensional instability of the anterior cruciate deficient knee. J Bone Joint Surg [Br] 70:777–783
Lerat JL, Moyen B, Dupre-Latour L, Mainetti E, Lalain JJ, Brunet G (1988) Mesure des laxités antérieures du genou par radiographies dynamiques et par l'arthromètre KT 1000. Rev Chir Orthop 74 [Suppl II]:194–197
Levy IM, Torzilli PA, Warren RF (1982) The effect of medial meniscectomy on anterior posterior motion of the knee. J Bone Joint Surg [Am] 64:883–887
Levy IM, Torzilli PA, Gould JD, Warren RF (1989) The effect of lateral meniscectomy on motion of the knee. J Bone Joint Surg [Am] 71:401–406
Markolt KL, Mensh JS, Amstutz HC (1976) Stiffness and laxity of the knee. The contributions of the supporting structures. A quantitative in vitro study. J Bone Joint Surg [Am] 58:583–593
Markolf KL, Bargar WL, Shoemaker SC, Amstutz HC (1981) The role of joint load in knee stability. J Bone Joint Surg [Am] 63:570–585
Nielsen S, Helmig P (1986) The static stabilizing function of the popliteal tendon in the knee. A experimental study. Arch Orthop Trauma Surg 104:357–362
Paulos L, Noyes FR, Grood E, Butler DL (1981) Knee rehabilitation after anterior cruciate ligament reconstruction and repair. Am J Sports Med 9:140–149
Perry J, Antonelli D, Ford W (1975) Analysis of knee joint forces during flexed knee stance. J Bone Joint Surg [Am] 57:961–967
Piziali RL, Seering WP, Nagel DA, Schumman DJ (1980) The function of the primary ligaments of the knee in anterior-posterior and medial-lateral motions. J Biomech 13:777–784
Renström P, Arms SW, Stanwyck TS, Johnson RJ, Pope MH (1986) Strain within the anterior cruciate ligament during hamstring and quadriceps activity. Am J Sports Med 14:83–87
Reuben JD, Rovick JS, Schrager RJ, Walker PS, Boland AL (1989) Three dimensional dynamic motion analysis of the anterior cruciate ligament deficient knee joint. Am J Sports Med 17:463–471
Shermann QH, Markolf KL, Ferkel RD (1987) Measurements of anterior laxity in normal and anterior cruciate absent knees with two instrumented test devices. Clin Orthop 215:156–161
Shino K, Inove M, Horibe S, Nakamura H (1987) Measurement of anterior instability of the knee a new apparatus for clinical testing. J Bone Joint Surg [Br] 69:608–614
Shocmaker SC, Markolf KL (1985) Effects of joint load on the stiffness and laxity of ligament-deficient knees: an in vitro study of the anterior cruciate and medial collateral ligaments. J Bone Joint Surg [Am] 67:136–146
Shoemaker SC, Markolf KL (1986) The role of the meniscus in the anterior-posterior stability of the loaded anterior cruciate deficient knee: effects of partial versus total excision. J Bone Joint Surg [Am] 68:71–79
Smidt GL (1973) Biomechanical analysis of knee flexion and extension. J Biomech 6:79–92
Solomonow M, Baratta R, Zhou BH, Shoji H, Bose W, Beck C, D'Ambrosia R (1987) The synergistic action of the anterior cruciate ligament and thigh muscles in maintaining joint stability. J Am Sports Med 15:207–213
Sullivan D, Levy IM, Sheskier S, Torzilli PA, Warren RF (1984) Medial restraints to anterior-posterior motion of the knee. J Bone Joint Surg [Am] 66:930–937
Torg JS, Conrd W (1976) Clinical diagnosis of anterior cruciate ligament instability in athlete. Am J Sports Med 4:84–93
Yasuda K, Sasaki T (1987) Muscle Exercise after anterior cruciate ligament reconstruction. Biomechanics of the simultaneous isometric contraction method of the quadriceps and the hamstrings. Clin Orthop 220:266–274
Yasuda K, Sasaki T (1987) Exercise after anterior cruciate ligament reconstruction. The force exerted on the tibia by the separate isometric contraction of the quadriceps or the hamstrings. Clin Orthop 220:275–283
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Bonnin, M., Carret, J.P., Dimnet, J. et al. The weight-bearing knee after anterior cruciate ligament rupture. Knee Surg, Sports traumatol, Arthroscopy 3, 245–251 (1996). https://doi.org/10.1007/BF01466627
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DOI: https://doi.org/10.1007/BF01466627