Belisle Adelle L, Bicos James, Geaney Lauren, Andersen Matthew H, Obopilwe Elifho, Rincon Lina, Nyland John, Morgan Craig, Caborn David N M, Arciero Robert A
University of Connecticut Health Center, Farmington, Connecticut, USA.
Arthroscopy. 2007 Nov;23(11):1210-7. doi: 10.1016/j.arthro.2007.06.021.
The purpose of this study was to dynamically assess the native strain patterns of the anteromedial bundle (AMB) and posterolateral bundle (PLB) of the anterior cruciate ligament (ACL) and compare these findings with graft bundle strain patterns after double-bundle (DB) ACL reconstruction with tibial fixation under 40 N of tension at 75 degrees knee flexion (AMB) and under 20 N of tension at 20 degrees knee flexion (PLB) and after single-bundle (SB) reconstruction with tibial fixation under 40 N of tension at 20 degrees knee flexion.
The mean strain pattern of the AMB and PLB of the native ACL of 4 cadaveric knees was measured via differential variable reluctance transducers and 2-dimensional kinematic analysis during passive manual knee flexion-extension under a constant axial compression load. Measurements were repeated after DB and SB ACL reconstruction. Celeration line assessments with a split-middle technique were performed to quantify percent strain/knee flexion-extension angle change at reciprocating bundle function transition points.
The DB ACL reconstruction technique displayed reciprocating AMB and PLB strain patterns that more closely replicated those of the native ACL. The SB ACL reconstruction technique tended to replicate AMB strain patterns, suggesting poor bundle function differentiation.
The DB ACL reconstruction with differential AMB and PLB tensioning more closely replicated native ACL strain patterns than the SB ACL reconstruction. The SB ACL reconstruction that we used closely simulated native ACL AMB strain patterns; however, PLB function was not restored.
The DB ACL reconstruction more closely replicated the AMB and PLB strain patterns of the native ACL.
本研究旨在动态评估前交叉韧带（ACL）前内侧束（AMB）和后外侧束（PLB）的天然应变模式，并将这些结果与双束（DB）ACL重建术后移植束的应变模式进行比较。DB ACL重建采用胫骨固定，在膝关节屈曲75度时施加40 N张力（AMB），在膝关节屈曲20度时施加20 N张力（PLB）；单束（SB）重建采用胫骨固定，在膝关节屈曲20度时施加40 N张力。
通过差动可变磁阻传感器和二维运动学分析，在恒定轴向压缩负荷下被动手动屈伸膝关节时，测量4具尸体膝关节天然ACL的AMB和PLB的平均应变模式。在DB和SB ACL重建后重复测量。采用分裂中间技术进行加速度线评估，以量化往复束功能转换点处的应变百分比/膝关节屈伸角度变化。
DB ACL重建技术显示出往复式AMB和PLB应变模式，更接近天然ACL的应变模式。SB ACL重建技术倾向于复制AMB应变模式，表明束功能分化较差。
与SB ACL重建相比，采用不同AMB和PLB张力的DB ACL重建更接近天然ACL应变模式。我们使用的SB ACL重建紧密模拟了天然ACL的AMB应变模式；然而，PLB功能未恢复。
DB ACL重建更接近天然ACL的AMB和PLB应变模式。
