AJSM signin
HOME HELP CONTACT US SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Sign In to gain access to subscriptions and/or personal tools.
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Request Reprints
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Mannor, D. A.
Right arrow Articles by Levy, M. S.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Mannor, D. A.
Right arrow Articles by Levy, M. S.
Related Collections
Right arrow Kinematics and kinetics
The American Journal of Sports Medicine 28:833-845 (2000)
© 2000 American Orthopaedic Society for Sports Medicine

Two-Bundle Posterior Cruciate Ligament Reconstruction

An In Vitro Analysis of Graft Placement and Tension

Dana A. Mannor, MD{dagger}, Jason T. Shearn, MS{ddagger}, Edward S. Grood, PhD{ddagger},§, Frank R. Noyes, MD{dagger} and Martin S. Levy, PhD||

{ddagger} Noyes-Giannestras Biomechanics Laboratories, Department of Aerospace Engineering and Engineering Mechanics, University of Cincinnati, Cincinnati, Ohio
|| Department of Quantitative Analysis, University of Cincinnati, Cincinnati, Ohio
{dagger} Cincinnati Sportsmedicine and Orthopaedic Center, Cincinnati, Ohio

Presented at the interim meeting of the AOSSM, Anaheim, California, February 1999.

§ Address correspondence and reprint requests to Edward S. Grood, PhD, Noyes-Giannestras Biomechanics Laboratories, University of Cincinnati, 2901 Campus Drive, Mail Location 70, Cincinnati, OH 45221-0070

This study had two purposes: first, to determine how femoral attachment location affects the load sharing between the two bundles of a Y-type posterior cruciate ligament reconstruction, and second, to determine how the bundles, separately and in combination, control posterior tibial translation throughout the full range of knee flexion. One and two-bundle reconstructions were performed in 12 cadaveric knees. The one-bundle reconstructions were attached within the femoral posterior cruciate ligament footprint at one of three locations, high and shallow (S1), mid and shallow (S2), or mid and deep (D). The two-bundle reconstructions comprised an S1 bundle with either an S2 or a D bundle. Posterior translation and bundle tension were measured as the knee was flexed from full extension to 120° of flexion while a posterior force of either 50 or 100 N was applied to the proximal tibia. The shallow one-bundle reconstruction restored posterior translation to within 2 mm of that of the intact knee over the entire range of knee flexion. The deep reconstruction did not control abnormal posterior translation above 45°. The tension in the shallow bundles increased with knee flexion, and the deep bundle tension remained nearly constant throughout knee flexion. Both two-bundle reconstructions controlled posterior translation, but with different load-sharing characteristics. The S1-S2 configuration resisted posterior tibial translation as both bundles became taut in flexion. In contrast, the S1-D configuration resisted posterior translation in a reciprocal fashion with the D bundle tension being the greatest in extension and the S1 bundle tension being the greatest tension in flexion.




This article has been cited by other articles:


Home page
 Am J Sports MedHome page
S. Apsingi, T. Nguyen, A. M. J. Bull, A. Unwin, D. J. Deehan, and A. A. Amis
Control of Laxity in Knees With Combined Posterior Cruciate Ligament and Posterolateral Corner Deficiency: Comparison of Single-Bundle Versus Double-Bundle Posterior Cruciate Ligament Reconstruction Combined With Modified Larson Posterolateral Corner Reconstruction
Am. J. Sports Med., March 1, 2008; 36(3): 487 - 494.
[Abstract] [Full Text] [PDF]

Home page
 JBJSHome page
O. V. Lopes Jr., M. Ferretti, W. Shen, M. Ekdahl, P. Smolinski, and F. H. Fu
Topography of the Femoral Attachment of the Posterior Cruciate Ligament
J. Bone Joint Surg. Am., February 1, 2008; 90(2): 249 - 255.
[Abstract] [Full Text] [PDF]

Home page
 JBJSHome page
K. L. Markolf, B. T. Feeley, S. R. Jackson, and D. R. McAllister
Biomechanical Studies of Double-Bundle Posterior Cruciate Ligament Reconstructions
J. Bone Joint Surg. Am., August 1, 2006; 88(8): 1788 - 1794.
[Abstract] [Full Text] [PDF]

Home page
 Am J Sports MedHome page
W. B. Wiley, M. J. Askew, A. Melby III, and D. A. Noe
Kinematics of the Posterior Cruciate Ligament/Posterolateral Corner-Injured Knee After Reconstruction by Single- and Double-Bundle Intra-articular Grafts
Am. J. Sports Med., May 1, 2006; 34(5): 741 - 748.
[Abstract] [Full Text] [PDF]

Home page
 Am J Sports MedHome page
K. L. Markolf, B. T. Feeley, S. R. Jackson, and D. R. McAllister
Where Should the Femoral Tunnel of a Posterior Cruciate Ligament Reconstruction Be Placed to Best Restore Anteroposterior Laxity and Ligament Forces?
Am. J. Sports Med., April 1, 2006; 34(4): 604 - 611.
[Abstract] [Full Text] [PDF]

Home page
 Am J Sports MedHome page
W. Petersen, S. Lenschow, A. Weimann, M. J. Strobel, M. J. Raschke, and T. Zantop
Importance of Femoral Tunnel Placement in Double-Bundle Posterior Cruciate Ligament Reconstruction: Biomechanical Analysis Using a Robotic/Universal Force-Moment Sensor Testing System
Am. J. Sports Med., March 1, 2006; 34(3): 456 - 463.
[Abstract] [Full Text] [PDF]

Home page
 Am J Sports MedHome page
J. A. Bergfeld, S. M. Graham, R. D. Parker, A. D. C. Valdevit, and H. E. Kambic
A Biomechanical Comparison of Posterior Cruciate Ligament Reconstructions Using Single- and Double-Bundle Tibial Inlay Techniques
Am. J. Sports Med., July 1, 2005; 33(7): 976 - 981.
[Abstract] [Full Text] [PDF]

Home page
 JBJSHome page
F. R. Noyes and S. Barber-Westin
Posterior Cruciate Ligament Replacement with a Two-Strand Quadriceps Tendon-Patellar Bone Autograft and a Tibial Inlay Technique
J. Bone Joint Surg. Am., June 1, 2005; 87(6): 1241 - 1252.
[Abstract] [Full Text] [PDF]

Home page
 Am J Sports MedHome page
F. R. Noyes and S. D. Barber-Westin
Posterior Cruciate Ligament Revision Reconstruction, Part 1: Causes of Surgical Failure in 52 Consecutive Operations
Am. J. Sports Med., May 1, 2005; 33(5): 646 - 654.
[Abstract] [Full Text] [PDF]

Home page
 Am J Sports MedHome page
F. R. Noyes and S. D. Barber-Westin
Posterior Cruciate Ligament Revision Reconstruction, Part 2: Results of Revision Using a 2-Strand Quadriceps Tendon-Patellar Bone Autograft
Am. J. Sports Med., May 1, 2005; 33(5): 655 - 665.
[Abstract] [Full Text] [PDF]

Home page
 Am J Sports MedHome page
J. K. Sekiya, M. J. Haemmerle, K. J. Stabile, T. M. Vogrin, and C. D. Harner
Biomechanical Analysis of a Combined Double-Bundle Posterior Cruciate Ligament and Posterolateral Corner Reconstruction
Am. J. Sports Med., March 1, 2005; 33(3): 360 - 369.
[Abstract] [Full Text] [PDF]

Home page
 Am J Sports MedHome page
L. E. DeFrate, T. J. Gill, and G. Li
In Vivo Function of the Posterior Cruciate Ligament During Weightbearing Knee Flexion
Am. J. Sports Med., December 1, 2004; 32(8): 1923 - 1928.
[Abstract] [Full Text] [PDF]

Home page
 JBJSHome page
J. T. Shearn, E. S. Grood, F. R. Noyes, and M. S. Levy
Two-Bundle Posterior Cruciate Ligament Reconstruction: How Bundle Tension Depends on Femoral Placement
J. Bone Joint Surg. Am., June 1, 2004; 86(6): 1262 - 1270.
[Abstract] [Full Text] [PDF]

Home page
 Am J Sports MedHome page
L. E. DeFrate, A. van der Ven, T. J. Gill, and G. Li
The Effect of Length on the Structural Properties of an Achilles Tendon Graft as Used in Posterior Cruciate Ligament Reconstruction
Am. J. Sports Med., June 1, 2004; 32(4): 993 - 997.
[Abstract] [Full Text] [PDF]

Home page
 Am J Sports MedHome page
F. Margheritini, C. S. Mauro, J. A. Rihn, K. J. Stabile, S. L-Y. Woo, and C. D. Harner
Biomechanical Comparison of Tibial Inlay Versus Transtibial Techniques for Posterior Cruciate Ligament Reconstruction: Analysis of Knee Kinematics and Graft In Situ Forces
Am. J. Sports Med., April 1, 2004; 32(3): 587 - 593.
[Abstract] [Full Text] [PDF]

Home page
 Am J Sports MedHome page
F. R. Noyes and J. P. Stannard
Anatomic reconstruction of the posterior cruciate ligament after multiligament knee injuries. A combination of the tibial-inlay and two-femoral-tunnel techniques.
Am. J. Sports Med., September 1, 2003; 31(5): 812 - 813.
[Full Text] [PDF]

Home page
 Am J Sports MedHome page
T. J. Gill, L. E. DeFrate, C. Wang, C. T. Carey, S. Zayontz, B. Zarins, and G. Li
The Biomechanical Effect of Posterior Cruciate Ligament Reconstruction on Knee Joint Function: Kinematic Response to Simulated Muscle Loads
Am. J. Sports Med., July 1, 2003; 31(4): 530 - 536.
[Abstract] [Full Text] [PDF]

Home page
 Am J Sports MedHome page
E. A. Mejia, F. R. Noyes, and E. S. Grood
Posterior Cruciate Ligament Femoral Insertion Site Characteristics: Importance for Reconstructive Procedures
Am. J. Sports Med., September 1, 2002; 30(5): 643 - 651.
[Abstract] [Full Text] [PDF]


HOME HELP CONTACT US SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2000 by the American Orthopaedic Society for Sports Medicine.