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Factors affecting graft force in surgical reconstruction of the anterior cruciate ligament
Author(s) -
Lewis Jack L.,
Lew William D.,
Engebretsen Lars,
Hunter Robert E.,
Kowalczyk Curtis
Publication year - 1990
Publication title -
journal of orthopaedic research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.041
H-Index - 155
eISSN - 1554-527X
pISSN - 0736-0266
DOI - 10.1002/jor.1100080407
Subject(s) - cadaver , anterior cruciate ligament , medicine , knee flexion , anatomy , anterior cruciate ligament reconstruction , biomechanics , surgery , orthodontics
The effect of the maximum unloaded graft length (L o ) and femoral fixation hole location on graft force with the knee under anteriorly directed tibial loads was measured in five fresh cadaver knees with a reconstruction of the anterior cruciate ligament (ACL). The reconstruction was performed using a composite graft consisting of the semitendinosus and gracilis tendons augmented with the Kennedy ligament augmentation device (LAD). Buckle transducers were used to measure ligament and graft forces. The total graft force was adjusted to match the intact ACL at 30° flexion using a force‐setting method so that a standardized reference configuration could be repeatedly obtained. The graft force was highly sensitive to L 0 , typically changing by 50% with a change in L 0 of 3 mm. Variation in femoral hole location of 5 mm anterior, posterior, proximal, and distal to the anatomic position produced changes in graft force, particularly at 60° and 90° flexion; however, these changes were not statistically significant. The effect of femoral hole location varied considerably between knees. This variability makes predicting proper hole placement difficult, and suggests the need to adjust each knee at surgery to account for this variable femoral hole position sensitivity.