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Section of Orthopaedic Surgery and Rehabilitation Medicine, Department of Surgery, The University of Chicago, Chicago, Illinois
* Address correspondence and reprint requests to Louis F. Draganich, PhD, The University of Chicago, Section of Orthopaedics and Rehabilitation Medicine, Department of Surgery, 5841 South Maryland Avenue/MC 3079, Chicago, IL 60637
Seven cadaveric knees were used to investigate the effects of removal and reconstruction of the anterior cruciate ligament with a bone-patellar tendon-bone graft on contact characteristics of the patellofemoral joint during physiologic levels of quadriceps muscle loads at 30°, 60°, and 90° of knee flexion. Loads were applied to the quadriceps tendon to equilibrate externally applied flexion moments equivalent to one-third of values for maximum isometric extension moments. Patellofemoral contact areas and pressures were measured using pressure-sensitive film. Excision of the anterior cruciate ligament resulted in significant decreases in the total patellofemoral contact area by as much as 94 mm2 (68%), the medial facet contact area by as much as 55 mm2 (93%), the combined average contact pressure by 0.7 MPa (21%), the medial facet average contact pressure by 2.3 MPa (70%), the combined peak contact pressure by 3.0 MPa (38%), and the medial facet peak contact pressure by 5.4 MPa (76%), all at 30° of knee flexion. Excision of the anterior cruciate ligament also resulted in significant decreases in total, medial facet, and lateral facet patellofemoral contact areas at 60° and 90° of knee flexion. Intraarticular reconstruction returned these to levels not significantly different from those of the intact knee.
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