Effects of initial graft tension on the tibiofemoral compressive forces and joint position after anterior cruciate ligament reconstruction
Effects of initial graft tension on the tibiofemoral compressive forces and joint position after anterior cruciate ligament reconstruction
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DOI：
10.1177/0363546506294363
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发表时间：
2007-03-01
影响因子：
4.8
通讯作者：
Banerjee, Rahul
中科院分区：
文献类型：
--
作者：
Brady, Mark F.;Bradley, Michael P.;Banerjee, Rahul
背景：固定时施加于前交叉韧带移植物的初始张力调节膝关节运动和胫股骨压缩载荷。目的：建立初始移植物张力、胫股骨压缩力和尸体膝关节中胫股骨中立位置之间的关系。研究设计：对照实验室研究。方法：确定前十字韧带中的胫股骨压缩力和关节位置膝关节屈曲 0 度、20 度和 90 度时韧带完好。切除前交叉韧带，并用髌腱移植物重建，在膝关节屈曲 0 度、20 度和 90 度时施加 1、15、30、60 和 90 N 的移植物张力。比较初始张力条件和前交叉韧带完整膝关节之间的压缩力和中立位置。结果：增加初始移植物张力会增加胫股骨压缩力。内侧隔室中的力是外侧隔室中的1.8倍。压缩力取决于施加张力时的膝盖角度。当膝关节伸展时移植物受到拉紧时，产生最大的压缩力。与前十字韧带完整的膝关节相比，初始移植物张力的增加导致胫骨向外旋转（在膝关节屈曲 0 度和 90 度时拉紧至 90 N 时分别外旋 1.5 度和 7.7 度）。初始移植物张力的增加还导致胫骨相对于股骨显着向后平移（在膝关节屈曲 0 度和 90 度时，当张紧至 90 N 时，后平移分别为 0.9 和 5.3 毫米）。结论：不同的初始移植物张力方案会产生胫股骨压缩力和关节位置的可预测变化。临床相关性：在低移植物张力下，胫骨股骨压缩力和中立关节位置最好复制(1-15 N) 当使用髌腱移植物时。
Background: The initial tension applied to an anterior cruciate ligament graft at the time of fixation modulates knee motion and the tibiofemoral compressive loads.Purpose: To establish the relationships between initial graft tension, tibiofemoral compressive force, and the neutral tibiofemoral position in the cadaveric knee.Study Design: Controlled laboratory study.Methods: The tibiofemoral compressive forces and joint positions were determined in the anterior cruciate ligament-intact knee at 0 degrees, 20 degrees, and 90 degrees of knee flexion. The anterior cruciate ligament was excised and reconstructed with a patellar tendon graft using graft tensions of 1, 15, 30, 60, and 90 N applied at 0 degrees, 20 degrees, and 90 degrees of knee flexion. The compressive forces and neutral positions were compared between initial tension conditions and the anterior cruciate ligament-intact knee.Results: Increasing initial graft tension increased the tibiofemoral compressive forces. The forces in the medial compartment were 1.8 times those in the lateral compartment. The compressive forces were dependent on the knee angle at which the tension was applied. The greatest compressive forces occurred when the graft was tensioned with the knee in extension. An increase in initial graft tension caused the tibia to rotate externally compared with the anterior cruciate ligament-intact knee (1.5 degrees and 7.7 degrees of external rotation when tensioned to 90 N at 0 degrees and 90 degrees of knee flexion, respectively). Increases in initial graft tension also caused a significant posterior translation of the tibia relative to the femur (0.9 and 5.3 mm of posterior translation when tensioned to 90 N at 0 degrees and 90 degrees of knee flexion, respectively).Conclusion: Different initial graft tension protocols produced predictable changes in the tibiofemoral compressive forces and joint positions.Clinical Relevance: The tibiofemoral compressive force and neutral joint position were best replicated with a low graft tension (1-15 N) when using a patellar tendon graft.