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.
First published on November 22, 2005, doi:10.1177/0363546505281239
This version was published on March 1, 2006
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
34/3/456    most recent
0363546505281239v1
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 ISI Web of Science (5)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Petersen, W.
Right arrow Articles by Zantop, T.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Petersen, W.
Right arrow Articles by Zantop, T.
Related Collections
Right arrow Knee
Right arrow Operative
Right arrow Biomechanics
Right arrow Kinematics and kinetics
The American Journal of Sports Medicine 34:456-463 (2006)
© 2006 American Orthopaedic Society for Sports Medicine

Importance of Femoral Tunnel Placement in Double-Bundle Posterior Cruciate Ligament Reconstruction

Biomechanical Analysis Using a Robotic/Universal Force-Moment Sensor Testing System

Wolf Petersen, MD*, Simon Lenschow, MS{dagger}, Andre Weimann, MD*, Michael J. Strobel, MD{ddagger}, Michael J. Raschke, MD* and Thore Zantop, MD*,§

From the * Department of Trauma-, Hand-, and Reconstructive Surgery, Wilhelms University Muenster, Muenster, Germany, the {dagger} Department of Orthopaedic Surgery, Christian-Albrechts-University Kiel, Kiel, Germany, and the {ddagger} Orthopädische Gemeinschaftspraxis Straubing, Straubing, Germany

§ Address correspondence to Thore Zantop, MD, Department of Trauma-, Hand-, and Reconstructive Surgery, Wilhelms University Muenster, Waldeyerstr. 1, D-48149 Muenster, Germany (e-mail: thore.zantop{at}ukmuenster.de).

Background: Previous studies have identified the femoral attachment of the posterior cruciate ligament fibers as one of the primary determinants of fiber tension behavior. In addition, a double-bundle posterior cruciate ligament reconstruction has been shown to restore the intact knee kinematics more closely than does a single-bundle reconstruction.

Hypothesis: An anterior tunnel position in double-bundle posterior cruciate ligament reconstruction restores the biomechanics of the normal knee more closely than does a posterior tunnel position.

Study Design: Controlled laboratory study.

Methods: Kinematics and in situ forces of human knees after double-bundle posterior cruciate ligament reconstruction with 2 different femoral tunnel positions (anterior vs posterior) were evaluated using a robotic/universal force-moment sensor testing system. Within the same specimen, the resulting knee kinematics and in situ forces were compared. For statistical analysis, 2-way analysis of variance repeated measures were performed.

Results: The femoral tunnel position of the double-bundle hamstring graft had significant effect on the resulting posterior tibial displacement and in situ forces of the hamstring grafts. The anterior femoral tunnel position provided significantly less posterior tibial translation than did the posterior tunnel position. There was a tendency toward higher in situ forces of grafts fixed in the anterior tunnel when compared to the posterior position, but this difference was statistically not significant.

Conclusion: An anterior position of the bone tunnels in double-bundle posterior cruciate ligament reconstruction restores the normal knee kinematics more closely than does a posterior position of the tunnels.

Clinical Relevance: In double-bundle posterior cruciate ligament reconstruction, posterior placement of the tunnel should be avoided.

Key Words: knee • posterior cruciate ligament • hamstring graft • in situ forces • kinematics • robotics • double bundle




This article has been cited by other articles:


Home page
 Am J Sports MedHome page
T. Zantop, M. Ferretti, K. M. Bell, P. U. Brucker, L. Gilbertson, and F. H. Fu
Effect of Tunnel-Graft Length on the Biomechanics of Anterior Cruciate Ligament-Reconstructed Knees: Intra-articular Study in a Goat Model
Am. J. Sports Med., November 1, 2008; 36(11): 2158 - 2166.
[Abstract] [Full Text] [PDF]

Home page
 Am J Sports MedHome page
W. Petersen, S. Loerch, S. Schanz, M. Raschke, and T. Zantop
The Role of the Posterior Oblique Ligament in Controlling Posterior Tibial Translation in the Posterior Cruciate Ligament-Deficient Knee
Am. J. Sports Med., March 1, 2008; 36(3): 495 - 501.
[Abstract] [Full Text] [PDF]

Home page
 Am J Sports MedHome page
W. Petersen, H. Tretow, A. Weimann, M. Herbort, F. H. Fu, M. Raschke, and T. Zantop
Biomechanical Evaluation of Two Techniques for Double-Bundle Anterior Cruciate Ligament Reconstruction: One Tibial Tunnel Versus Two Tibial Tunnels
Am. J. Sports Med., February 1, 2007; 35(2): 228 - 234.
[Abstract] [Full Text] [PDF]

Home page
 Am J Sports MedHome page
T. Zantop, M. Herbort, M. J. Raschke, F. H. Fu, and W. Petersen
The Role of the Anteromedial and Posterolateral Bundles of the Anterior Cruciate Ligament in Anterior Tibial Translation and Internal Rotation
Am. J. Sports Med., February 1, 2007; 35(2): 223 - 227.
[Abstract] [Full Text] [PDF]


HOME HELP CONTACT US SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2006 by the American Orthopaedic Society for Sports Medicine.