Skip to main content
SpringerLink
Log in

Can Joint Contact Dynamics Be Restored by Anterior Cruciate Ligament Reconstruction?

  • Symposium: Tscherne Festschrift
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

Rotational kinematics has become an important consideration after ACL reconstruction because of its possible influence on knee degeneration. However, it remains unknown whether ACL reconstruction can restore both rotational kinematics and normal joint contact patterns, especially during functional activities.

Questions/purposes

We asked whether knee kinematics (tibial anterior translation and axial rotation) and joint contact mechanics (tibiofemoral sliding distance) would be restored by double-bundle (DB) or single-bundle (SB) reconstruction.

Methods

We retrospectively studied 17 patients who underwent ACL reconstruction by the SB (n = 7) or DB (n = 10) procedure. We used dynamic stereo x-ray to capture biplane radiographic images of the knee during downhill treadmill running. Tibial anterior translation, axial rotation, and joint sliding distance in the medial and lateral compartments were compared between reconstructed and contralateral knees in both SB and DB groups.

Results

We observed reduced anterior tibial translation and increased knee rotation in the reconstructed knees compared to the contralateral knees in both SB and DB groups. The mean joint sliding distance on the medial compartment was larger in the reconstructed knees than in the contralateral knees for both the SB group (9.5 ± 3.9 mm versus 7.5 ± 4.3 mm) and the DB group (11.1 ± 1.3 mm versus 7.9 ± 3.8 mm).

Conclusions

Neither ACL reconstruction procedure restored normal knee kinematics or medial joint sliding.

Clinical Relevance

Further study is necessary to understand the clinical significance of abnormal joint contact, identify the responsible mechanisms, and optimize reconstruction procedures for restoring normal joint mechanics after ACL injury.

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. 1A–B
Fig. 2
Fig. 3
Fig. 4
Fig. 5A–B
Fig. 6A–B

Similar content being viewed by others

References

  1. Abebe ES, Utturkar GM, Taylor DC, Spritzer CE, Kim JP, Moorman CT 3rd, Garrett WE, DeFrate LE. The effects of femoral graft placement on in vivo knee kinematics after anterior cruciate ligament reconstruction. J Biomech. 2011;44:924–929.

    Article  CAS  PubMed  Google Scholar 

  2. Anderst W, Zauel R, Bishop J, Demps E, Tashman S. Validation of three-dimensional model-based tibio-femoral tracking during running. Med Eng Phys. 2009;31:10–16.

    Article  PubMed  Google Scholar 

  3. Anderst WJ, Tashman S. The association between velocity of the center of closest proximity on subchondral bones and osteoarthritis progression. J Orthop Res. 2009;27:71–77.

    Article  PubMed  Google Scholar 

  4. Andriacchi TP, Briant PL, Bevill SL, Koo S. Rotational changes at the knee after ACL injury cause cartilage thinning. Clin Orthop Relat Res. 2006;442:39–44.

    Article  PubMed  Google Scholar 

  5. Andriacchi TP, Mundermann A, Smith RL, Alexander EJ, Dyrby CO, Koo S. A framework for the in vivo pathomechanics of osteoarthritis at the knee. Ann Biomed Eng. 2004;32:447–457.

    Article  PubMed  Google Scholar 

  6. Barrance PJ, Williams GN, Snyder-Mackler L, Buchanan TS. Altered knee kinematics in ACL-deficient non-copers: a comparison using dynamic MRI. J Orthop Res. 2006;24:132–140.

    Article  PubMed  Google Scholar 

  7. Bedi A, Musahl V, O’Loughlin P, Maak T, Citak M, Dixon P, Pearle AD. A comparison of the effect of central anatomical single-bundle anterior cruciate ligament reconstruction and double-bundle anterior cruciate ligament reconstruction on pivot-shift kinematics. Am J Sports Med. 2010;38:1788–1794.

    Article  PubMed  Google Scholar 

  8. Brandsson S, Karlsson J, Sward L, Kartus J, Eriksson BI, Karrholm J. Kinematics and laxity of the knee joint after anterior cruciate ligament reconstruction: pre- and postoperative radiostereometric studies. Am J Sports Med. 2002;30:361–367.

    PubMed  Google Scholar 

  9. Cha PS, Brucker PU, West RV, Zelle BA, Yagi M, Kurosaka M, Fu FH. Arthroscopic double-bundle anterior cruciate ligament reconstruction: an anatomic approach. Arthroscopy. 2005;21:1275.

    PubMed  Google Scholar 

  10. Chaudhari AM, Briant PL, Bevill SL, Koo S, Andriacchi TP. Knee kinematics, cartilage morphology, and osteoarthritis after ACL injury. Med Sci Sports Exerc. 2008;40:215–222.

    Article  PubMed  Google Scholar 

  11. Claes S, Neven E, Callewaert B, Desloovere K, Bellemans J. Tibial rotation in single- and double-bundle ACL reconstruction: a kinematic 3-D in vivo analysis. Knee Surg Sports Traumatol Arthrosc. 2011;19(suppl 1):S115–S121.

    Article  PubMed  Google Scholar 

  12. Cohen SB, Fu FH. Three-portal technique for anterior cruciate ligament reconstruction: use of a central medial portal. Arthroscopy. 2007;23:325.e1–5.

    Google Scholar 

  13. Deneweth JM, Bey MJ, McLean SG, Lock TR, Kolowich PA, Tashman S. Tibiofemoral joint kinematics of the anterior cruciate ligament-reconstructed knee during a single-legged hop landing. Am J Sports Med. 2010;38:1820–1828.

    Article  PubMed  Google Scholar 

  14. Fu FH, Shen W, Starman JS, Okeke N, Irrgang JJ. Primary anatomic double-bundle anterior cruciate ligament reconstruction: a preliminary 2-year prospective study. Am J Sports Med. 2008;36:1263–1274.

    Article  PubMed  Google Scholar 

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

    PubMed  Google Scholar 

  16. Grood ES, Suntay WJ. A joint coordinate system for the clinical description of three-dimensional motions: application to the knee. J Biomech Eng. 1983;105:136–144.

    Article  CAS  PubMed  Google Scholar 

  17. Harner CD, Honkamp NJ, Ranawat A. Anteromedial portal technique for creating the anterior cruciate ligament femoral tunnel. Arthroscopy. 2008;24:113–115.

    Article  PubMed  Google Scholar 

  18. Hemmerich A, van der Merwe W, Batterham M, Vaughan CL. Double-bundle ACL surgery demonstrates superior rotational kinematics to single-bundle technique during dynamic task. Clin Biomech (Bristol, Avon). 2011;26:998–1004.

    Google Scholar 

  19. Hemmerich A, van der Merwe W, Batterham M, Vaughan CL. Knee rotational laxity in a randomized comparison of single- versus double-bundle anterior cruciate ligament reconstruction. Am J Sports Med. 2011;39:48–56.

    Article  PubMed  Google Scholar 

  20. Ho JY, Gardiner A, Shah V, Steiner ME. Equal kinematics between central anatomic single-bundle and double-bundle anterior cruciate ligament reconstructions. Arthroscopy. 2009;25:464–472.

    Article  PubMed  Google Scholar 

  21. Hoshino Y, Tashman S. Internal tibial rotation during in vivo, dynamic activity induces greater sliding of tibio-femoral joint contact on the medial compartment. Knee Surg Sports Traumatol Arthrosc. 2012;20:1268–1275.

    Article  PubMed  Google Scholar 

  22. Irrgang JJ, Harner CD. Recent advances in ACL rehabilitation: clinical factors that influence the program. J Sport Rehabil. 1997;6:111–124.

    Google Scholar 

  23. Irrgang JJ, Tashman S, Moore C, Fu FH. Challenge accepted: description of an ongoing NIH-funded randomized clinical trial to compare anatomic single-bundle versus anatomic double-bundle ACL reconstruction. Arthroscopy. 2012;28:745–748.

    Article  PubMed  Google Scholar 

  24. Kanaya A, Ochi M, Deie M, Adachi N, Nishimori M, Nakamae A. Intraoperative evaluation of anteroposterior and rotational stabilities in anterior cruciate ligament reconstruction: lower femoral tunnel placed single-bundle versus double-bundle reconstruction. Knee Surg Sports Traumatol Arthrosc. 2009;17:907–913.

    Article  PubMed  Google Scholar 

  25. Kuster M, Wood GA, Sakurai S, Blatter G. Downhill walking: a stressful task for the anterior cruciate ligament? A biomechanical study with clinical implications. Knee Surg Sports Traumatol Arthrosc. 1994;2:2–7.

    Article  CAS  PubMed  Google Scholar 

  26. Lam MH, Fong DT, Yung PS, Ho EP, Fung KY, Chan KM. Knee rotational stability during pivoting movement is restored after anatomic double-bundle anterior cruciate ligament reconstruction. Am J Sports Med. 2011;39:1032–1038.

    Article  PubMed  Google Scholar 

  27. Li G, Moses JM, Papannagari R, Pathare NP, DeFrate LE, Gill TJ. Anterior cruciate ligament deficiency alters the in vivo motion of the tibiofemoral cartilage contact points in both the anteroposterior and mediolateral directions. J Bone Joint Surg Am. 2006;88:1826–1834.

    Article  PubMed  Google Scholar 

  28. Morimoto Y, Ferretti M, Ekdahl M, Smolinski P, Fu FH. Tibiofemoral joint contact area and pressure after single- and double-bundle anterior cruciate ligament reconstruction. Arthroscopy. 2009;25:62–69.

    Article  PubMed  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  30. Scanlan SF, Chaudhari AM, Dyrby CO, Andriacchi TP. Differences in tibial rotation during walking in ACL reconstructed and healthy contralateral knees. J Biomech. 2010;43:1817–1822.

    Article  PubMed  Google Scholar 

  31. Seon JK, Park SJ, Lee KB, Yoon TR, Seo HY, Song EK. Stability comparison of anterior cruciate ligament between double- and single-bundle reconstructions. Int Orthop. 2009;33:425–429.

    Article  PubMed  Google Scholar 

  32. Tashman S, Collon D, Anderson K, Kolowich P, Anderst W. Abnormal rotation knee motion during running after anterior cruciate ligament reconstruction. Am J Sports Med. 2004;32:975–983.

    Article  PubMed  Google Scholar 

  33. Tashman S, Kolowich P, Collon D, Anderson K, Anderst W. Dynamic function of the ACL-reconstructed knee during running. Clin Orthop Relat Res. 2007;454:66–73.

    Article  PubMed  Google Scholar 

  34. Tsarouhas A, Iosifidis M, Kotzamitelos D, Spyropoulos G, Tsatalas T, Giakas G. Three-dimensional kinematic and kinetic analysis of knee rotational stability after single- and double-bundle anterior cruciate ligament reconstruction. Arthroscopy. 2010;26:885–893.

    Article  PubMed  Google Scholar 

  35. van Eck CF, Illingworth KD, Fu FH. Quadriceps tendon: the forgotten graft. Arthroscopy. 2010;26:441?442.

    Google Scholar 

  36. van Eck CF, Lesniak BP, Schreiber VM, Fu FH. Anatomic single- and double-bundle anterior cruciate ligament reconstruction flowchart. Arthroscopy. 2010;26:258–268.

    Article  PubMed  Google Scholar 

  37. van Eck CF, Schreiber VM, Liu TT, Fu FH. The anatomic approach to primary, revision and augmentation anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. 2010;18:1154–1163.

    Article  PubMed  Google Scholar 

  38. Wilson W, van Burken C, van Donkelaar C, Buma P, van Rietbergen B, Huiskes R. Causes of mechanically induced collagen damage in articular cartilage. J Orthop Res. 2006;24:220–228.

    Article  PubMed  Google Scholar 

  39. Yagi M, Wong EK, Kanamori A, Debski RE, Fu FH, Woo SL. Biomechanical analysis of an anatomic anterior cruciate ligament reconstruction. Am J Sports Med. 2002;30:660–666.

    PubMed  Google Scholar 

  40. Yamamoto Y, Hsu WH, Woo SL, Van Scyoc AH, Takakura Y, Debski RE. Knee stability and graft function after anterior cruciate ligament reconstruction: a comparison of a lateral and an anatomical femoral tunnel placement. Am J Sports Med. 2004;32:1825–1832.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors thank Gele Moloney, MD, and Eric Thorhauer, BS, for their contributions to data collection, processing, and analysis.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of Pittsburgh, 3471 Fifth Avenue, Pittsburgh, PA, 15213, USA

    Yuichi Hoshino MD, PhD, Freddie H. Fu MD, DSc, James J. Irrgang PT, PhD, ATC, FAPTA & Scott Tashman PhD

  2. Department of Orthopaedic Surgery, Kobe University, Kobe, Hyogo, Japan

    Yuichi Hoshino MD, PhD

Authors
  1. Yuichi Hoshino MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Freddie H. Fu MD, DSc
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. James J. Irrgang PT, PhD, ATC, FAPTA
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Scott Tashman PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to Freddie H. Fu MD, DSc or Scott Tashman PhD.

Additional information

Each author certifies that he or she, or a member of his or her immediate family, has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request.

Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

This study was performed in Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA.

About this article

Cite this article

Hoshino, Y., Fu, F.H., Irrgang, J.J. et al. Can Joint Contact Dynamics Be Restored by Anterior Cruciate Ligament Reconstruction?. Clin Orthop Relat Res 471, 2924–2931 (2013). https://doi.org/10.1007/s11999-012-2761-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11999-012-2761-1

Keywords

Search

Navigation