Skip to main content
SpringerLink
Log in

Does a lateral plasty control coupled translation during antero-posterior stress in single-bundle ACL reconstruction? An in vivo study

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

Abstract

The objective of this study was to quantify, in vivo, the reduction of knee laxity obtained by an extra-articular procedure, added to hamstring single-bundle (SB) anterior cruciate ligament (ACL) reconstruction in controlling coupled tibial translation during the Lachman and drawer tests. Twenty-eight patients were evaluated with a computer-assisted kinematic evaluation protocol; patients with associated ligament tears or meniscal damages were not included in the study. All patients underwent an hamstring ACL with an additional extra-articular procedure. During the intervention, tibia was tracked during the Lachman and drawer tests with ACL-deficient knee, after SB fixation and after extra-articular plasty fixation, performed with the remnant part of the hamstring tendons, from end of lateral condyle to Gerdy’s tubercle. Statistical analysis was performed to see whether there was a difference in knee laxity after the tests in the three steps. At 30°, the SB graft reduces AP translation of about 5 mm (P < 0.05) while the extra-articular procedure controls lateral tibial compartment, reducing translation by 1.6 mm (P < 0.05). At 90° the SB graft reduces AP translation more in the lateral compartment (P < 0.05), while the extra-articular procedure contributes in controlling tibial translation reducing laxity by 1 mm (P < 0.05) in both compartments. Result shows that, in vivo, the addition of an extra-articular procedure to single-bundle ACL reconstruction may be effective in controlling coupled tibial translation during the Lachman test and reduces AP laxity at 90° of flexion.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Bach BRJ, Tradonsky S, Bojchuk J, Levy ME, Bush-Joseph CA et al (1998) Arthroscopically assisted anterior cruciate ligament reconstruction using patellar tendon autograft: five- to nine-year follow-up evaluation. Am J Sports Med 26:20–29

    PubMed  Google Scholar 

  2. Beynnon BD, Johnson RJ, Fleming BC, Kannus P, Kaplan M et al (2002) Anterior cruciate ligament replacement: comparison of bone-patellar tendon-bone grafts with two-strand hamstring grafts: a prospective, randomized study. J Bone Joint Surg Am 84-A:1503–1513

    PubMed  Google Scholar 

  3. Carson WGJ (1988) The role of lateral extra-articular procedures for anterolateral rotatory instability. Clin Sports Med 7:751–772

    PubMed  Google Scholar 

  4. Colombet P, Robinson J, Christel P, Franceschi J, Djian P (2007) Using navigation to measure rotation kinematics during ACL reconstruction. Clin Orthop Relat Res 454:59–65

    Article  PubMed  Google Scholar 

  5. Draganich LF, Reider B, Ling M, Samuelson M (1990) An in vitro study of an intraarticular and extraarticular reconstruction in the anterior cruciate ligament deficient knee. Am J Sports Med 18:262–266

    Article  PubMed  CAS  Google Scholar 

  6. Engebretsen L, Lew WD, Lewis JL, Hunter RE (1990) The effect of an iliotibial tenodesis on intraarticular graft forces and knee joint motion. Am J Sports Med 18:169–176

    Article  PubMed  CAS  Google Scholar 

  7. Freedman KB, D’Amato MJ, Nedeff DD, Kaz A, Bach BRJ (2003) Arthroscopic anterior cruciate ligament reconstruction: a metaanalysis comparing patellar tendon and hamstring tendon autografts. Am J Sports Med 31:2–11

    PubMed  Google Scholar 

  8. Gabriel MT, Wong EK, Woo SL, Yagi M, Debski RE (2004) Distribution of in situ forces in the anterior cruciate ligament in response to rotatory loads. J Orthop Res 22:85–89

    Article  PubMed  Google Scholar 

  9. Georgoulis AD, Papadonikolakis A, Papageorgiou CD, Mitsou A, Stergiou N (2003) Three-dimensional tibiofemoral kinematics of the anterior cruciate ligament-deficient and reconstructed knee during walking. Am J Sports Med 31:75–79

    PubMed  Google Scholar 

  10. Harner CD, Baek GH, Vogrin TM, Carlin GJ, Kashiwaguchi S et al (1999) Quantitative analysis of human cruciate ligament insertions. Arthroscopy 15:741–749

    Article  PubMed  CAS  Google Scholar 

  11. Igić R (2006) Publication in peer-reviewed medical journals. J BUON 11:405–410

    PubMed  Google Scholar 

  12. Jansson KA, Linko E, Sandelin J, Harilainen A (2003) A prospective randomized study of patellar versus hamstring tendon autografts for anterior cruciate ligament reconstruction. Am J Sports Med 31:12–18

    PubMed  Google Scholar 

  13. Jensen JE, Slocum DB, Larson RL, James SL, Singer KM (1983) Reconstruction procedures for anterior cruciate ligament insufficiency: a computer analysis of clinical results. Am J Sports Med 11:240–248

    Article  PubMed  CAS  Google Scholar 

  14. Jonsson H, Riklund-Ahlström K, Lind J (2004) Positive pivot shift after ACL reconstruction predicts later osteoarthrosis: 63 patients followed 5–9 years after surgery. Acta Orthop Scand 75:594–599

    Article  PubMed  Google Scholar 

  15. Kocher MS, Steadman JR, Briggs KK, Sterett WI, Hawkins RJ (2004) Relationships between objective assessment of ligament stability and subjective assessment of symptoms and function after anterior cruciate ligament reconstruction. Am J Sports Med 32:629–634

    Article  PubMed  Google Scholar 

  16. Leitze Z, Losee RE, Jokl P, Johnson TR, Feagin JA (2005) Implications of the pivot shift in the ACL-deficient knee. Clin Orthop Relat Res 436:229–236

    Article  PubMed  Google Scholar 

  17. Lenth RV (2007) Statistical power calculations. J Anim Sci 85:E24–E29

    Article  PubMed  CAS  Google Scholar 

  18. Lerat JL, Chotel F, Besse JL, Moyen B, Binet G et al (1998) The results after 10–16 years of the treatment of chronic anterior laxity of the knee using reconstruction of the anterior cruciate ligament with a patellar tendon graft combined with an external extra-articular reconstruction. Rev Chir Orthop Reparatrice Appar Mot 84:712–727

    PubMed  CAS  Google Scholar 

  19. Lie DTT, Bull AMJ, Amis AA (2006) Persistence of the mini pivot shift after anatomically placed anterior cruciate ligament reconstruction. Clin Orthop Relat Res 457:203–209

    Google Scholar 

  20. Lie DTT, Bull AMJ, Amis AA (2007) Persistence of the mini pivot shift after anatomically placed anterior cruciate ligament reconstruction. Clin Orthop Relat Res 457:203–209

    PubMed  Google Scholar 

  21. Lobenhoffer P, Posel P, Witt S, Piehler J, Wirth CJ (1987) Distal femoral fixation of the iliotibial tract. Arch Orthop Trauma Surg 106:285–290

    Article  PubMed  CAS  Google Scholar 

  22. Logan MC, Williams A, Lavelle J, Gedroyc W, Freeman M (2004) Tibiofemoral kinematics following successful anterior cruciate ligament reconstruction using dynamic multiple resonance imaging. Am J Sports Med 32:984–992

    Article  PubMed  Google Scholar 

  23. Marcacci M, Zaffagnini S, Iacono F, Neri MP, Loreti I et al (1998) Arthroscopic intra- and extra-articular anterior cruciate ligament reconstruction with gracilis and semitendinosus tendons. Knee Surg Sports Traumatol Arthrosc 6:68–75

    Article  PubMed  CAS  Google Scholar 

  24. Marcacci M, Zaffagnini S, Iacono F, Vascellari A, Loreti I et al (2003) Intra- and extra-articular anterior cruciate ligament reconstruction utilizing autogeneous semitendinosus and gracilis tendons: 5-year clinical results. Knee Surg Sports Traumatol Arthrosc 11:2–8

    PubMed  Google Scholar 

  25. Martelli S, Lopomo N, Bignozzi S, Zaffagnini S, Visani A (2006) Validation of a new protocol for navigated intraoperative assessment of knee kinematics. Comput Biol Med 37:872–878

    Article  PubMed  Google Scholar 

  26. Martelli S, Lopomo N, Greggio S, Ferretti E, Visani A (2006) Development and applications of a software tool for diarthrodial joint analysis. Comput Methods Programs Biomed 83:50–56

    Article  PubMed  Google Scholar 

  27. Martelli S, Zaffagnini S, Bignozzi S, Lopomo N, Marcacci M (2007) Description and validation of a navigation system for intra-operative evaluation of knee laxity. Comput Aided Surg 12:181–188

    Article  PubMed  Google Scholar 

  28. Meister BR, Michael SP, Moyer RA, Kelly JD, Schneck CD (2000) Anatomy and kinematics of the lateral collateral ligament of the knee. Am J Sports Med 28:869–878

    PubMed  CAS  Google Scholar 

  29. Monaco E, Labianca L, Conteduca F, De Carli A, Ferretti A (2007) Double bundle or single bundle plus extraarticular tenodesis in ACL reconstruction? A CAOS study. Knee Surg Sports Traumatol Arthrosc 15:1168–1174

    Article  PubMed  CAS  Google Scholar 

  30. Noyes FR, Barber SD (1991) The effect of an extra-articular procedure on allograft reconstructions for chronic ruptures of the anterior cruciate ligament. J Bone Joint Surg Am 73:882–892

    PubMed  CAS  Google Scholar 

  31. Noyes FR, Grood ES, Cummings JF, Wroble RR (1991) An analysis of the pivot shift phenomenon: the knee motions and subluxations induced by different examiners. Am J Sports Med 19:148–155

    Article  PubMed  CAS  Google Scholar 

  32. O’Brien SJ, Warren RF, Wickiewicz TL, Rawlins BA, Allen AA et al (1991) The iliotibial band lateral sling procedure and its effect on the results of anterior cruciate ligament reconstruction. Am J Sports Med 19:21–24 discussion 24–25

    Article  PubMed  CAS  Google Scholar 

  33. Petersen W, Zantop T (2007) Anatomy of the anterior cruciate ligament with regard to its two bundles. Clin Orthop Relat Res 454:35–47

    Article  PubMed  Google Scholar 

  34. Ramaniraka NA, Saunier P, Siegrist O, Pioletti DP (2007) Biomechanical evaluation of intra-articular and extra-articular procedures in anterior cruciate ligament reconstruction: a finite element analysis. Clin Biomech (Bristol, Avon) 22:336–343

    Article  CAS  Google Scholar 

  35. Ristanis S, Giakas G, Papageorgiou CD, Moraiti T, Stergiou N et al (2003) The effects of anterior cruciate ligament reconstruction on tibial rotation during pivoting after descending stairs. Knee Surg Sports Traumatol Arthrosc 11:360–365

    Article  PubMed  CAS  Google Scholar 

  36. Roth JH, Kennedy JC, Lockstadt H, McCallum CL, Cunning LA (1987) Intra-articular reconstruction of the anterior cruciate ligament with and without extra-articular supplementation by transfer of the biceps femoris tendon. J Bone Joint Surg Am 69:275–278

    PubMed  CAS  Google Scholar 

  37. Sakane M, Fox RJ, Woo SL, Livesay GA, Li G et al (1997) In situ forces in the anterior cruciate ligament and its bundles in response to anterior tibial loads. J Orthop Res 15:285–293

    Article  PubMed  CAS  Google Scholar 

  38. Strum GM, Fox JM, Ferkel RD, Dorey FH, Del Pizzo W et al. (1989) Intraarticular versus intraarticular and extraarticular reconstruction for chronic anterior cruciate ligament instability. Clin Orthop Relat Res 245:188–198

    Google Scholar 

  39. Zaffagnini S, Bignozzi S, Martelli S, Imakiire N, Lopomo N et al (2006) New intraoperative protocol for kinematic evaluation of ACL reconstruction: preliminary results. Knee Surg Sports Traumatol Arthrosc 14:811–816

    Article  PubMed  CAS  Google Scholar 

  40. Zaffagnini S, Marcacci M, Lo Presti M, Giordano G, Iacono F et al (2006) Prospective and randomized evaluation of ACL reconstruction with three techniques: a clinical and radiographic evaluation at 5 years follow-up. Knee Surg Sports Traumatol Arthrosc 14:1060–1069

    Article  PubMed  Google Scholar 

  41. Zantop T, Schumacher T, Diermann N, Schanz S, Raschke MJ et al (2007) Anterolateral rotational knee instability: role of posterolateral structures: winner of the AGA-DonJoy award 2006. Arch Orthop Trauma Surg 127:743–752

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Laboratorio di Biomeccanica, Istituti Ortopedici Rizzoli, Via di Barbiano 1/10, 40136, Bologna, Italy

    Simone Bignozzi, Stefano Zaffagnini, Nicola Lopomo, Sandra Martelli, Francesco Iacono & Maurilio Marcacci

  2. Dipartimento di Bioingegneria, Politecnico di Milano, Milan, Italy

    Nicola Lopomo

Authors
  1. Simone Bignozzi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Stefano Zaffagnini
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Nicola Lopomo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sandra Martelli
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Francesco Iacono
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Maurilio Marcacci
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Simone Bignozzi.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bignozzi, S., Zaffagnini, S., Lopomo, N. et al. Does a lateral plasty control coupled translation during antero-posterior stress in single-bundle ACL reconstruction? An in vivo study. Knee Surg Sports Traumatol Arthr 17, 65–70 (2009). https://doi.org/10.1007/s00167-008-0651-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00167-008-0651-6

Keywords

Search

Navigation