The use of a robotic system for the determination and assessment of the 3-bundle ACL reconstruction

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A6-DOF robotic system was utilized for the determination and assessment of the 3-bundle ACL reconstruction technique in the present study. During the anterior and posterior force was applied to the human cadaveric knee specimens using the robotic system, the 3-dimensional motion, and force/moment applied to, the knee specimen were recorded. After the anteromedial bundle of the anterior cruciate ligament (ACL) was fransected the recorded 3-dimensional motion was reproduced to the knee specimen while the force/moment applied to the dissected knee were recorded. The same procedure was repeated after the dissection of the intermediate bundle and then the dissection of the posterolateral bundle. Under the principle of superposition, the forces carried by the three bundles were determined. Then the transected ACL was surgically reconstructed by simulating the 3-bundle ACL reconstruction technique using hamstring tendon grafts. Using three force transducers attached to the grafts, the forces carried by the ACL grafts were determined in response to externally applied loads to the knee specimen. In addition, the 3-dimensional motion of the ACL-reconstructed knee was determined. The same procedure was repeated for the knee specimen subjected to the 2-bundle ACL reconstruction technique. Results revealed that the AP laxity of both the triple bundle-and double bundle-reconstructed knee were matched to the intact AP laxity when the initial tension of the total grafts was set 12N. When the initial tension was 12N, the AP laxity was closer to intact level in the triple bundle-reconstructed knee in flexion angles higher than 60 degree. Moreoveg the force carried by the total grafts was lower in the triple bundle-reconstructed knee as compared with double bundle-reconstructed knee. It was suggested that the triple bundle ACL reconstruction may be superior to the traditional single bundle ACL reconstruction as well as the double bundle ACL reconstruction.