The biomechanical effect of tunnel placement on ACL graft forces in double‐bundle ACL reconstruction – A 3D computational simulation. Issue 4 (1st June 2017)

• Record Type: Journal Article
• Authors: Varady, Nathan H.; Kernkamp, Willem A.; Li, Jingsheng; Wang, Lianxin; Koga, Hiroshi; Asnis, Peter; Li, Guoan
• Is Part Of: International journal of medical robotics and computer assisted surgery. Volume 13:Issue 4(2017)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2017-06-01
• Subjects: ACL -- anatomic double‐bundle ACL reconstruction -- graft failure -- graft forces -- tunnel placement; Robotics in medicine -- Periodicals; Surgery -- Technological innovations -- Periodicals; Imaging systems in medicine -- Periodicals; 617.90285
• DOI: 10.1002/rcs.1840
• Languages: English
• ISSNs: 1478-5951

Abstract

Abstract: Background: The posterolateral (PL) graft experiences a high failure rate in anterior cruciate ligament double‐bundle (DB) reconstruction. It is hypothesized that tunnel positions could dramatically affect the graft forces. Methods: A validated computational model was used to simulate DB reconstruction with various femoral PL tunnel locations (8–11 mm center–center tunnel spacing). Graft fixation was simulated at both 0° and 30°. Knee biomechanics were examined with the knee under a 134 N anterior load and 400 N quadriceps load at 0°, 30°, 60°, and 90° of flexion. Graft forces, tibial translation, and tibial rotation were calculated. Results: PL graft forces at full extension increased with increasing tunnel spacing under both fixation settings, but the knee kinematics was not dramatically affected. Conclusion: Small changes in the femoral PL tunnel position could result in large changes in graft forces, implying that precise PL tunnel position is an important factor in a successful DB reconstruction.