Arthroscopy: The Journal of Arthroscopic and Related Surgery
Volume 26, Issue 2 , Pages 202-213 , February 2010

Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction: Kinematics and Knee Flexion Angle–Graft Tension Relation

  • Patrick J. Murray, M.D.

      Affiliations

    • Clarkstown Orthopedics, West Nyack, New York, U.S.A.
    • Corresponding Author InformationAddress correspondence and reprint requests to Patrick J. Murray, M.D., Clarkstown Orthopedics, 2 Crosfield Ave, Ste 422, West Nyack, NY 10994, U.S.A.
    • ,
  • Jerry W. Alexander, B.S.

      Affiliations

    • Institute of Orthopedic Research and Education, Houston, Texas, U.S.A.
    • ,
  • Jonathan E. Gold, B.S.

      Affiliations

    • Institute of Orthopedic Research and Education, Houston, Texas, U.S.A.
    • ,
  • Kurt D. Icenogle, B.A.

      Affiliations

    • Department of Orthopedic Sports Medicine, Baylor College of Medicine, Houston, Texas, U.S.A.
    • ,
  • Philip C. Noble, Ph.D.

      Affiliations

    • Department of Orthopedic Sports Medicine, Baylor College of Medicine, Houston, Texas, U.S.A.
    • ,
  • Walter R. Lowe, M.D.

      Affiliations

    • Department of Orthopedic Sports Medicine, Baylor College of Medicine, Houston, Texas, U.S.A.

Received 9 January 2009 ,Accepted 9 July 2009.

References 

  1. Amis AA, Dawkins GPC. Functional anatomy of the ACL. J Bone Joint Surg Br. 1991;73:260–267
  2. Bach JM, Hull ML, Patterson HA. Direct measurement of strain in the posterolateral bundle of the ACL. J Biomech. 1997;30:281–283
  3. Gabriel MT, Wong EK, Woo SL-Y, et al. Distribution of in situ forces in the anterior cruciate ligament in response to rotatory loads. J Orthop Res. 2004;22:85–89
  4. Mae T, Shino K, Matsumoto N, et al. Force sharing between two grafts in the anatomical two-bundle ACL reconstruction. Knee Surg Sports Traumatol Arthrosc. 2006;14:505–509
  5. Zantop T, Herbort M, Raschke MJ, Fu FH, Petersen W. The role of the anteromedial and posterolateral bundles of the anterior cruciate ligament in anterior tibial translation and internal rotation. Am J Sports Med. 2007;35:223–227
  6. Chhabra A, Starman JS, Ferretti M, Vidal AF, Zantop T, Fu FH. Anatomic, radiographic, biomechanical and kinematic evaluation of the ACL and its 2 functional bundles. J Bone Joint Surg Am. 2006;88:2–10
  7. Ristanis S, Stergiou N, Patras K, et al. Excessive tibial rotation during high-demand activities is not restored by anterior cruciate ligament reconstruction. Arthroscopy. 2005;21:1323–1329
  8. Tashman S, Collon D, Anderson K, et al. Abnormal rotational knee motion during running after anterior cruciate ligament reconstruction. Am J Sports Med. 2004;32:975–983
  9. Belisle AL, Bicos J, Geaney L, et al. Strain pattern comparison of double- and single-bundle anterior cruciate ligament reconstruction techniques with the native anterior cruciate ligament. Arthroscopy. 2007;23:1210–1217
  10. Jarvela T. Double-bundle versus single-bundle anterior cruciate ligament reconstruction: A prospective randomized clinical study. Knee Surg Sports Traumatol Arthrosc. 2007;15:500–507
  11. Muneta T, Koga H, Mochizuki T, et al. A prospective randomized study of 4-strand semitendinosus tendon anterior cruciate ligament reconstruction comparing single-bundle and double-bundle techniques. Arthroscopy. 2007;23:618–628
  12. Tjoumakaris FP, Buoncrisiani A, Starman JS, Fu FH. Anatomic double-bundle ACL reconstruction using tibialis anterior allograft. Oper Tech Sports Med. 2007;15:62–67
  13. Miura K, Woo SL, Brinkley R, Fu Y-C, Noorani S. Effects of knee flexion angles for graft fixation on force distribution in double-bundle anterior cruciate ligament grafts. Am J Sports Med. 2006;34:577–585
  14. Siebold R, Dehler C, Ellert T. Prospective randomized comparison of double-bundle versus single-bundle anterior cruciate ligament reconstruction. Arthroscopy. 2008;24:137–145
  15. Streich NA, Friedrich K, Gotterbarm T, Schmitt H. Reconstruction of the ACL with a semitendinosus tendon graft: A prospective randomized single blinded comparison of double-bundle versus single-bundle technique in male athletes. Knee Surg Sports Traumatol Arthrosc. 2008;16:232–238
  16. Vercillo F, Woo SL, Noorani SY, Dede O. Determination of a safe range of knee flexion angles for fixation of the grafts in double-bundle anterior cruciate ligament reconstruction: A human cadaveric study. Am J Sports Med. 2007;35:1513–1520
  17. Cuomo P, Boddu Siva Rama KR, Bull AM, Amis AA. The effects of different tensioning strategies on knee laxity and graft tension after double-bundle anterior cruciate ligament reconstruction. Am J Sports Med. 2007;35:2083–2090
  18. Jordan SS, DeFrate LE, Nha KW, Papannagari R, Gill TJ, Li G. The in vivo kinematics of the anteromedial and posterolateral bundles of the anterior cruciate ligament during weightbearing knee flexion. Am J Sports Med. 2007;35:547–554
  19. Muneta T, Koga H, Morito T, Yagishita K, Sekiya I. A retrospective study of the midterm outcome of 2-bundle ACL reconstruction using quadrupled semitendinosus tendon in comparison with 1-bundle reconstruction. Arthroscopy. 2006;22:252–258
  20. Otsubo H, Shino K, Nakamura N, et al. Arthroscopic evaluation of ACL grafts reconstructed with the anatomical two-bundle technique using hamstring tendon autograft. Knee Surg Sports Traumatol Arthrosc. 2007;15:720–728
  21. Yasuda K, Kindo E, Ichiyama H, et al. Anatomic reconstruction of the AM and PL bundles of the ACL using hamstring tendon grafts. Arthroscopy. 2004;20:1015–1025
  22. Kanamori A, Zeminski J, Rudy TW, Li G, Fu FH, Woo SL-Y. The effect of axial tibial torque on the function of the anterior cruciate ligament: A biomechanical study of a simulated pivot shift test. Arthroscopy. 2002;18:394–398
  23. Patil S, Colwell C, Ezzet K, D'Lima D. Can normal knee kinematics be restored with unicompartmental knee replacement?. J Bone Joint Surg Am. 2005;87:332–338
  24. Eckhoff D, Bach J, Spitzer V, et al. Three-dimensional morphology and kinematics of the distal part of the femur viewed in virtual reality. J Bone Joint Surg Am. 2003;85(Suppl 4):97–104
  25. Iwaki H, Pinskerova V, Freeman M. Tibiofemoral movement 1: The shapes and relative movements of the femur and the tibia in the unloaded cadaver knee. J Bone Joint Surg Br. 2000;82:1189–1195
  26. Hill P, Williams A, Iwaki H, Pinskerova V, Freeman M. Tibiofemoral movement 2: The loaded and unloaded living knee studied by MRI. J Bone Joint Surg Br. 2000;82:1196–1198
  27. Most E, Li G, Sultan P, Park S, Rubash H. Kinematic analysis of conventional and high-flexion cruciate-retaining total knee arthroplasties. J Arthroplasty. 2005;20:529–535
  28. Zantop T, Wellman M, Fu FH, Petersen W. Tunnel positioning of anteromedial and posterolateral bundles in anatomic anterior cruciate ligament reconstructions: Anatomic and radiographic findings. Am J Sports Med. 2008;36:65–72
  29. Bernard M, Hertel P, Hornung H, Cierpinski T. Femoral insertion of the ACL (Radiographic quadrant method). Am J Knee Surg. 1997;10:14–21
  30. Stäubli HU, Rauschning W. Tibial attachment area of the anterior cruciate ligament in the extended knee position (Anatomy and cryosections in vitro complemented by magnetic resonance arthrography in vivo). Knee Surg Sports Traumatol Arthrosc. 1994;2:138–146
  31. Zantop T, Diermann N, Schumacker T, Schanz S, Fu FH, Petersen W. Anatomical and non-anatomical double-bundle anterior cruciate ligament reconstruction: Importance of femoral tunnel location on knee kinematics. Am J Sports Med. 2008;36:678–685
  32. Markolf KL, Gorek JF, Kabo JM, Shapiro MS. Direct measurement of resultant forces in the anterior cruciate ligament: An in vitro study performed with a new experimental technique. J Bone Joint Surg Am. 1990;72:557–567
  33. Palmer I. On the injuries to the ligaments of the knee joint. Acta Chir Scand. 1938;91:282
  34. Girgis FG, Marshall JL, Monajem ARS. The cruciate ligaments of the knee joint: Anatomical, functional and experimental analysis. Clin Orthop Relat Res. 1975;216–231
  35. Adachi N, Ochi M, Uchio Y, et al. Reconstruction of the ACL: Single vs. double-bundle multistranded hamstring tendons. J Bone Joint Surg Br. 2004;86:515–520
  36. Hoshino Y, Yuroda R, Nagamune K, et al. The effect of graft tensioning in anatomic 2-bundle ACL reconstruction on knee joint kinematics. Knee Surg Sports Traumatol Arthrosc. 2007;15:508–514
  37. Mae T, Shino K, Nakata K, Toritsuka Y, Otsubo H, Fujie H. Optimization of graft fixation at the time of anterior cruciate ligament reconstruction: Part 1: Effect of initial tension. Am J Sports Med. 2008;36:1087–1093
  38. Mae T, Shino K, Nakata K, Toritsuka Y, Otsubo H, Fujie H. Optimization of graft fixation at the time of anterior cruciate ligament reconstruction: Part 2: Effect of knee flexion angle. Am J Sports Med. 2008;36:1094–1100
  39. Yasuda K, Ichiyama H, Kondo E, Miyatake S, Inoue M, Tanabe Y. An in-vivo biomechanical study on the tension-versus-knee flexion angle curves of 2 grafts in anatomic double-bundle anterior cruciate ligament reconstruction: Effects of initial tension and internal tibial rotation. Arthroscopy. 2008;24:276–284
  40. Abramowitch SD, Papageorgiou JD, Withrow JD, Gilbert TW, Woo SL-Y. The effect of initial graft tension on the biomechanical properties of a healing ACL replacement graft: A study in goats. J Orthop Res. 2003;21:708–715

 The authors report no conflict of interest.

PII: S0749-8063(09)00613-6

doi: 10.1016/j.arthro.2009.07.014

Arthroscopy: The Journal of Arthroscopic and Related Surgery
Volume 26, Issue 2 , Pages 202-213 , February 2010

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