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Tibial rotation in single- and double-bundle ACL reconstruction: a kinematic 3-D in vivo analysis

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

Abstract

Purpose

The effect of double-bundle ACL reconstruction on knee kinematics has recently been studied by several authors under controlled laboratory conditions however little evidence has been derived from dynamic in vivo evaluations. This study hypothesized that tibial rotation during pivoting motor tasks would be better restored after double-bundle ACL reconstructions when compared with single-bundle procedures.

Methods

Twenty patients with a chronic ACL rupture were randomly assigned to receive a single- or double-bundle ACL reconstruction. Both knees were evaluated pre-operatively by kinematic 3-D gait analysis while performing low- and high-demand motor tasks, including pivoting. At 6 months post-operatively, measurements were repeated in 16 patients. Ten healthy, sex- and age-matched subjects with no history of lower limb pathology formed the control group. The tibial rotational excursion was set as the dependent variable.

Results

The results indicate that at 6 months after surgery both “anatomic” single- and double-bundle ACL reconstruction are able to restore tibial rotational excursion when compared with the contralateral knees and with control knees from uninjured subjects. Chronic ACL-deficient patients show an increase in tibial rotation in both knees during high-demand pivoting tasks.

Conclusions

Both “anatomic” single- and double-bundle ACL reconstruction adequately restore tibial rotational excursion in a human, “in vivo” kinematic model. As knee stability measurements by in vivo kinematic 3-D analysis more accurately represent actual knee loading during activities, the results of this study might better correlate with functional outcome after ACL reconstructions compared with static knee stability tests or ex vivo laboratory experiments. In such, the results of this dynamic study do not support the theoretical advantage of a double-bundle ACL reconstruction over an “anatomic” single-bundle ACL reconstruction.

Level of evidence

II.

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Acknowledgments

The authors with like to express their appreciation to Dr. Pieter D’Hooghe, Ben Molenaers, and Katrien Fagard for their efforts concerning this study. The authors declare no potential conflict of interest regarding this study.

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Authors and Affiliations

  1. Department of Orthopedics and Traumatology, University Hospitals Leuven, Campus Pellenberg, Weligerveld 1, 3212, Pellenberg, Belgium

    Steven Claes, Enrico Neven & Johan Bellemans

  2. Clinical Motion Analysis Laboratory, Department of Rehabilitation Sciences, University Hospital Leuven, Pellenberg, Belgium

    Barbara Callewaert & Kaat Desloovere

Authors
  1. Steven Claes
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  2. Enrico Neven
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  3. Barbara Callewaert
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  4. Kaat Desloovere
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  5. Johan Bellemans
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Correspondence to Steven Claes.

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Claes, S., Neven, E., Callewaert, B. et al. Tibial rotation in single- and double-bundle ACL reconstruction: a kinematic 3-D in vivo analysis. Knee Surg Sports Traumatol Arthrosc 19 (Suppl 1), 115–121 (2011). https://doi.org/10.1007/s00167-011-1568-z

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  • DOI: https://doi.org/10.1007/s00167-011-1568-z

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