Native Anterior Cruciate Ligament Obliquity versus Anterior Cruciate Ligament Graft Obliquity
- 24 September 2008
- journal article
- research article
- Published by SAGE Publications in The American Journal of Sports Medicine
- Vol. 37 (1), 114-119
- https://doi.org/10.1177/0363546508323257
Abstract
Background: The goal of anterior cruciate ligament reconstruction is to attain a graft that closely resembles the native anterior cruciate ligament anatomy. By reconstructing the original anatomy, one hopes to eliminate issues related to graft elongation, impingement, and excessive tension while achieving ideal knee kinematics.Hypothesis: Clinical grafts placed using the transtibial technique will differ in the sagittal and coronal planes when compared with obliquity of the anatomic anterior cruciate ligament.Study Design: Controlled laboratory study/case series; Level of evidence, 4.Methods: With the assistance of computer navigation, our study compared the anterior cruciate ligament orientation of 5 cadaver knees with 12 clinical anterior cruciate ligament—reconstructed knees using the transtibial technique.Results: Clinical graft obliquity differed from the anatomic anterior cruciate ligament in all flexion angles 0°, 30°, 60°, and 90°. In the sagittal plane, the clinical graft obliquity differed from the anatomic anterior cruciate ligament by 13.6°, 12.7°, 16.7°, and 17°, respectively. In the coronal plane, the clinical graft obliquity differed from the anatomic anterior cruciate ligament by 4.9°, 7.6°, 8.9°, and 12.7°, respectively. Paired t tests demonstrated that the difference between the clinical and anatomic anterior cruciate ligament was significant (P < .05), except in the coronal plane at 0° of flexion. In spite of this, all patients demonstrated a negative pivot shift and Lachman at the conclusion of their reconstructions and at 6-month follow-up.Conclusion: The sagittal and coronal plane obliquity of well-functioning grafts placed using the transtibial technique were more vertical than anatomic fibers.Clinical Relevance: Graft obliquity, in both the coronal and sagittal plane, may be an important means to target appropriate anterior cruciate ligament graft position and can be monitored using surgical navigation systems.Keywords
This publication has 31 references indexed in Scilit:
- Reliability of Navigated Knee Stability ExaminationThe American Journal of Sports Medicine, 2007
- Effectiveness of Reconstruction of the Anterior Cruciate Ligament with Quadrupled Hamstrings and Bone-Patellar Tendon-Bone AutograftsThe American Journal of Sports Medicine, 2007
- Dynamic Function of the ACL-reconstructed Knee during RunningPublished by Ovid Technologies (Wolters Kluwer Health) ,2007
- Tibial Rotation is Not Restored after ACL Reconstruction with a Hamstring GraftClinical Orthopaedics and Related Research, 2007
- Anterior Cruciate Ligament Reconstruction Using NavigationThe American Journal of Sports Medicine, 2006
- Treatment of Anterior Cruciate Ligament Injuries, Part 2The American Journal of Sports Medicine, 2005
- Tibiofemoral Kinematics of the Anterior Cruciate Ligament (ACL)-Deficient Weightbearing, Living Knee Employing Vertical Access Open “Interventional” Multiple Resonance ImagingThe American Journal of Sports Medicine, 2004
- Kinematics after tear in the anterior cruciate ligament: Dynamic bilateral radiostereometric studies in 11 patientsActa Orthopaedica, 2001
- Comparative Tracking Error Analysis of Five Different Optical Tracking SystemsComputer Aided Surgery, 2000
- Tibial Tunnel Placement in Anterior Cruciate Ligament Reconstructions and Graft ImpingementPublished by Ovid Technologies (Wolters Kluwer Health) ,1992