Purpose
The purpose of this study was to clarify the changes in the kinematics of the knee
that result from isolated deficiency of the anteromedial (AM) or posterolateral (PL)
bundle.
Methods
Fourteen cadaveric knees were mounted in a 6-df rig and tested using the following 5 loading conditions: 90-N anterior and posterior
tibial loads, 5-Nm internal and external tibial torques, and a simulated pivot-shift
test. Tibiofemoral kinematics during flexion-extension was recorded with an optical
tracking system for (1) intact knees, (2) knees in which the isolated AM bundle was
cut, (3) knees in which the isolated PL bundle was cut, and (4) anterior cruciate
ligament (ACL)–deficient knees. The distances between the femoral and tibial attachments
of the AM and PL bundles of the ACL were also calculated.
Results
Anterior translation laxity under an anterior tibial load, rotational laxity under
an internal tibial torque, and anterior translation laxity under pivot-shift loading
were significantly different between the knees with AM and PL bundle deficiencies
(P < .024), but the changes were small: less than 3 mm or 1.5°. The AM bundle distance
increased significantly more after an AM bundle tear (P = .004) than after a PL bundle tear in flexion. Cutting the PL bundle did not have
a significant effect on the lengths between the bundle attachments.
Conclusions
An isolated AM or PL bundle tear caused a small increase in laxity (<3 mm or <1.5°).
Clinical Relevance
If there is a clinically identifiable increase in laxity, then—in addition to the
isolated tear of the AM or PL bundle—there must also be a tear of the other bundle
of the ACL, or at least a partial tear.
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Article info
Publication history
Accepted:
December 5,
2013
Received:
November 24,
2012
Footnotes
The authors report the following potential conflict of interest or source of funding: The knee specimens used in this study were purchased from the International Institute for the Advancement of Medicine, with funding from Smith & Nephew (Arthroscopy), which also lent the surgical instruments (E.K.). A.M.M. receives support from grants from the University of Malaya Medical Centre and the Arthritis Research Campaign.
Identification
Copyright
© 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
