Department of Orthopaedic Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
Clin Orthop Surg. 2012 Dec;4(4):249-55. doi: 10.4055/cios.2012.4.4.249. Epub 2012 Nov 16.
The purpose of this study was to compare the initial stability of anatomical and non-anatomical single bundle anterior cruciate ligament (ACL) reconstruction and to determine which would better restore intact knee kinematics. Our hypothesis was that the initial stability of anatomical single bundle ACL reconstruction would be superior to that of non-anatomical single bundle ACL reconstruction.
Anterior tibial translation (ATT) and internal rotation of the tibia were measured with a computer navigation system in seven pairs of fresh-frozen cadaveric knees under two testing conditions (manual maximum anterior force, and a manual maximum anterior force combined with an internal rotational force). Tests were performed at 0, 30, 60, and 90 degrees of flexion with the ACL intact, the ACL transected, and after reconstruction of one side of a pair with either anatomical or non-anatomical single bundle ACL reconstruction.
Under manual maximal anterior force, both reconstruction techniques showed no significant difference of ATT when compared to ACL intact knee state at 30° of knee flexion (p > 0.05). Under the combined anterior and internal rotatory force, non-anatomical single-bundle ACL reconstruction showed significant difference of ATT compared to those in ACL intact group (p < 0.05). In contrast, central anatomical single bundle ACL reconstruction showed no significant difference of ATT compared to those in ACL intact group (p > 0.05). Internal rotation of the tibia showed no significant difference in the ACL intact, the ACL transected, non-anatomical reconstructed and anatomical reconstructed knees.
Anatomical single bundle ACL reconstruction restored the initial stability closer to the native ACL under combined anterior and internal rotational forces when compared to non-anatomical ACL single bundle reconstruction.
本研究旨在比较解剖学和非解剖学单束前交叉韧带（ACL）重建的初始稳定性，并确定哪种方法更能恢复完整的膝关节运动学。我们的假设是解剖学单束 ACL 重建的初始稳定性优于非解剖学单束 ACL 重建。
在两种测试条件下（手动最大前向力和手动最大前向力加内旋力），使用计算机导航系统测量了 7 对新鲜冷冻尸体膝关节的胫骨前向平移（ATT）和胫骨内旋。在 ACL 完整、ACL 切断以及对每对膝关节的一侧进行解剖学或非解剖学单束 ACL 重建后，在 0、30、60 和 90 度膝关节屈曲下进行测试。
在手动最大前向力下，两种重建技术在 30°膝关节屈曲时与 ACL 完整膝关节状态相比，ATT 无显著差异（p>0.05）。在联合前向和内旋力下，非解剖学单束 ACL 重建与 ACL 完整组相比，ATT 有显著差异（p<0.05）。相比之下，中心解剖学单束 ACL 重建与 ACL 完整组相比，ATT 无显著差异（p>0.05）。胫骨内旋在 ACL 完整、ACL 切断、非解剖重建和解剖重建膝关节中无显著差异。
与非解剖学单束 ACL 重建相比，解剖学单束 ACL 重建在联合前向和内旋力下更能恢复接近正常 ACL 的初始稳定性。
