Search Filters

  • Media Source
  • Presentation Format
  • Media Type
  • Media Year
  • Language
  • Diagnosis / Condition
  • Diagnosis Method
  • Patient Populations
  • Treatment / Technique

Biomechanical Evaluation Of Knee Kinematics After ACL Reconstruction In Anatomic SB- And DB – Technique With Additional Medial Meniscus Suture


Olaf Lorbach, MD PhD
GERMANY

myRating

Biomechanical Evaluation Of Knee Kinematics After ACL Reconstruction In Anatomic SB- And DB – Technique With Additional Medial Meniscus Suture

Olaf Lorbach, MD PhD, GERMANY Martin Engelhardt, MD, GERMANY Mirco Herbort, MD, Prof., GERMANY Michael J. Raschke, Prof., GERMANY Matthias Kieb, MD, GERMANY

Münster University, Münster, Deutschland, GERMANY

2013 Congress   Paper Abstract   2013 Congress   Not yet rated

 

Patient Populations

Sport Specific Population

Anatomic Location

Knee

Anatomic Structure

Ligaments Meniscus Medial

Sports Medicine

Sport Specific Injuries Biomechanics

Treatment / Technique

Arthroscopy Double Bundle Repair / Reconstruction Single Bundle

Ligaments

ACL

Summary: Anterior tibial translation (aTT) as well as aTT in response to a combined rotatory load significantly increased with ACL deficiency compared to the intact knee, additional medial meniscal injury further increased aTT. Anatomic ACL reconstruction with medial meniscal repair restored knee kinematics compared to the intact knee.

Purpose

Evaluation of knee laxity after ACL reconstruction and additional suture of a medial meniscus tear Methods: Kinematics of the intact knee were determined in 12 human cadaver specimens in response to a 134-N anterior tibial load (aTT) and a combined rotatory load of 10 Nm valgus and 4 Nm internal tibial rotation using a robotic/universal force moment sensor testing system. Subsequently, the ACL was resected following the creation of a bucket-handle tear of the medial meniscus. A standard repair of the medial meniscus was performed using 3 inside-out horizontal sutures. Finally, The ACL was reconstructed using an anatomic single-bundle (6) or an anatomic double-bundle technique (6). Knee kinematics were determined following every sub-step. Results: Significant increase of aTT in the ACL- deficient knee was found with significant increase in the ACL-deficient knee with additional medial meniscal injury (p=.003; p=.009). ACL reconstructions significantly decreased aTT compared to the ACL-deficient knee. No significant differences between the intact knee and the ACL-reconstructed knee with additional meniscal repair. In response to a simulated pivot shift, aTT in the intact knee significantly increased in the ACL-deficient knee as well as in the meniscus injured/meniscus-sutured knee (p=.003;p=.007). No significant differences were found between the ACL-deficient and ACL-reconstructed knee with additional meniscal repair were seen. SB- as well as DB-ACL reconstruction with additional medial meniscal repair restored knee kinematics compared to the intact knee. Comparison of SB- versus DB- ACL reconstruction did not reveal any significant differences neither in a simulated Lachman test nor in tibial translation in response to a combined rotatory load (p=.05). Conclusions: ATT as well as aTT in response to a combined rotatory load significantly increased with ACL deficiency compared to the intact knee, additional medial meniscal injury further increased aTT. Anatomic ACL reconstruction with medial meniscal repair restored knee kinematics compared to the intact knee. Comparison of anatomic SB- vs. DB-ACL reconstruction with additional repair of the medial meniscus did not reveal significant differences in aTT as well as aTT under a combined rotatory load.