Methods: Native anterior cruciate ligament force and tibial rotat

Methods: Native anterior cruciate ligament force and tibial rotations were recorded during passive knee extension tests with and without applied tibial loads. The anteromedial and posterolateral bundles were reconstructed with patellar tendon tissue sized to fit tightly within 7-mm femoral tunnels. Testing was repeated with the anteromedial graft alone (single bundle), tensioned to restore anteroposterior

laxity at 30 degrees of flexion, and with double-bundle grafts. For double-bundle reconstructions, the anteromedial graft was first tensioned as above and then the posterolateral graft was tensioned with use of one of four protocols: posterolateral KU-55933 manufacturer tension = anteromedial tension at 10 degrees (DB1), posterolateral tension = anteromedial tension at 30 degrees

(DB2), posterolateral tension = (anteromedial tension Fer-1 mw + 30 N) at 10 degrees (DB3), and posterolateral tension = (anteromedial tension + 30 N) at 30 degrees (DB4).

Results: The posterolateral graft underwent a greater length change than the anteromedial graft between 0 degrees and 90 degrees. This difference in elongation patterns produced high forces in the posterolateral graft at 0 degrees when both grafts were tensioned and fixed at 30 degrees. The mean laxities for single-bundle reconstructions were within 1.1 mm of those of the intact knee between 0 degrees and 90 degrees; the mean graft force at 0 degrees was 76 N. The mean laxities for DB4 reconstructions were from 0.9 to 2.8 mm less than those of the intact knee, and the mean graft force at 0 degrees was 264 N. Coupled internal tibial rotations

from valgus moment were normal with the single-bundle graft. Internal rotations from tibial torque were approximately 2 degrees to 4 degrees greater than normal with a single-bundle graft. DB3 and DB4 reconstructions overcorrected the coupled tibial rotations from valgus moment and restored tibial rotations from internal torque to normal from 0 degrees to 45 degrees. The graft learn more forces from tibial torque and valgus moment were normal with the single-bundle graft. The mean double-bundle graft forces at 0 degrees were 57 N to 143 N and 34 N to 171 N greater than normal for internal torque and valgus moment, respectively.

Conclusions: The single-bundle reconstruction produced graft forces, knee laxities, and coupled tibial rotations that were closest to normal. Adding a posterolateral graft to an anteromedial graft tended to reduce laxities and tibial rotations, but the reductions were accompanied by markedly higher forces in the posterolateral graft near 0 degrees that occasionally caused it to fail during tests with internal torque or anterior tibial force.”
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