Tibial rotation under combined in vivo loading after single- and double-bundle anterior cruciate ligament reconstruction

Arthroscopy. 2011 Dec;27(12):1654-62. doi: 10.1016/j.arthro.2011.06.028. Epub 2011 Sep 19.

Abstract

Purpose: To evaluate in vivo the differences in tibial rotation between single- and double-bundle anterior cruciate ligament (ACL)-reconstructed knees under combined loading conditions.

Methods: An 8-camera optoelectronic system and a force plate were used to collect kinematic and kinetic data from 14 patients with double-bundle ACL reconstruction, 14 patients with single-bundle reconstruction, 12 ACL-deficient subjects, and 12 healthy control individuals while performing 2 tasks. The first included walking, 60° pivoting, and stair ascending, and the second included stair descending, 60° pivoting, and walking. The 2 variables evaluated were the maximum range of internal-external tibial rotation and the maximum knee rotational moment.

Results: Tibial rotation angles were not significantly different across the 4 groups (P = .331 and P = .851, respectively) or when side-to-side differences were compared within groups (P = .216 and P = .371, respectively) for the ascending and descending maneuvers, nor were rotational moments among the 4 groups (P = .418 and P = .290, respectively). Similarly, for the descending maneuver, the rotational moments were not significantly different between sides (P = .192). However, for the ascending maneuver, rotational moments of the affected sides were significantly lower by 20.5% and 18.7% compared with their intact counterparts in the single-bundle (P = .015) and double-bundle (P = .05) groups, respectively.

Conclusions: High-intensity activities combining stair ascending or descending with pivoting produce similar tibial rotation in single- and double-bundle ACL-reconstructed patients. During such maneuvers, the reconstructed knee may be subjected to significantly lower rotational loads compared with the intact knee.

Level of evidence: Level III, retrospective comparative study.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Anterior Cruciate Ligament / surgery*
  • Anterior Cruciate Ligament Injuries
  • Anterior Cruciate Ligament Reconstruction / methods*
  • Biomechanical Phenomena
  • Equipment Design
  • Follow-Up Studies
  • Humans
  • Knee Injuries / surgery*
  • Male
  • Retrospective Studies
  • Rotation
  • Rupture
  • Suture Techniques / instrumentation*
  • Sutures*
  • Tibia / surgery*
  • Treatment Outcome
  • Video Recording / instrumentation