Clin Orthop Surg.  2012 Dec;4(4):249-255. 10.4055/cios.2012.4.4.249.

Anatomical versus Non-Anatomical Single Bundle Anterior Cruciate Ligament Reconstruction: A Cadaveric Study of Comparison of Knee Stability

• Lim HC
• Yoon YC
• Wang JH
• Bae JH

• KMID: 1719291
• DOI: http://doi.org/10.4055/cios.2012.4.4.249

Abstract

BACKGROUND
The purpose of this study was to compare the initial stability of anatomical and non-anatomical single bundle anterior cruciate ligament (ACL) reconstruction and to determine which would better restore intact knee kinematics. Our hypothesis was that the initial stability of anatomical single bundle ACL reconstruction would be superior to that of non-anatomical single bundle ACL reconstruction.
METHODS
Anterior tibial translation (ATT) and internal rotation of the tibia were measured with a computer navigation system in seven pairs of fresh-frozen cadaveric knees under two testing conditions (manual maximum anterior force, and a manual maximum anterior force combined with an internal rotational force). Tests were performed at 0, 30, 60, and 90 degrees of flexion with the ACL intact, the ACL transected, and after reconstruction of one side of a pair with either anatomical or non-anatomical single bundle ACL reconstruction.
RESULTS
Under manual maximal anterior force, both reconstruction techniques showed no significant difference of ATT when compared to ACL intact knee state at 30degrees of knee flexion (p > 0.05). Under the combined anterior and internal rotatory force, non-anatomical single-bundle ACL reconstruction showed significant difference of ATT compared to those in ACL intact group (p < 0.05). In contrast, central anatomical single bundle ACL reconstruction showed no significant difference of ATT compared to those in ACL intact group (p > 0.05). Internal rotation of the tibia showed no significant difference in the ACL intact, the ACL transected, non-anatomical reconstructed and anatomical reconstructed knees.
CONCLUSIONS
Anatomical single bundle ACL reconstruction restored the initial stability closer to the native ACL under combined anterior and internal rotational forces when compared to non-anatomical ACL single bundle reconstruction.

Keyword

Anatomic; Non-anatomic; Anterior cruciate ligament; Transtibial; Single bundle

MeSH Terms

Aged
Aged, 80 and over
Anterior Cruciate Ligament/*anatomy & histology/physiology/*surgery
Anterior Cruciate Ligament Reconstruction/*methods
Biomechanics/physiology
Cadaver
Humans
Knee Joint/*anatomy & histology/physiology/*surgery
Middle Aged
Random Allocation
Range of Motion, Articular/physiology
Tibia/anatomy & histology/physiology/surgery

Figure

• 

  Fig. 1 Navigation software system (OrthoPilot ACL ver. 2.1, B. Braun-Aesculap) allowing the surgeon to measure the anterior translation of the tibia in millimeters and internal and external rotation of the tibia in degrees. This picture showed 16 mm of anterior translaton of the tibia, 23° of internal rotation and 12° of external rotation of the tibia at 30° of knee flexion under manual maximal anterior force in ACL deficient knee specimen. ACL: anterior cruciate ligament.

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