Purpose
To analyze the in vivo tibiofemoral cartilage contact patterns in knees undergoing
double-bundle anterior cruciate ligament reconstruction(DB-ACLR) with or without anterolateral
structure augmentation (ALSA).
Methods
Twenty patients with an ACL-ruptured knee and a healthy contralateral side were included.
Nine patients received an isolated DB-ACLR (DB-ACLR group), and 11 patients had a
DB-ACLR with ALSA (DB+ALSA group). At 1-year follow-up, a combined computed tomography,
magnetic resonance imaging, and dual fluoroscopy imaging system analysis was used
to capture a single-legged lunge of both the operated and healthy contralateral side.
Tibiofemoral contact points (CPs) of the medial and lateral compartments were compared.
CP locations were expressed as anteroposterior (AP, +/–) and medial–lateral (ML, –/+)
values according to the tibia.
Results
In the DB-ACLR knees, no significant differences were found in CPs when compared with
the healthy contralateral knees (P ≥ .31). However, in the DB+ALSA knees, the CPs in the lateral compartment had a significantly
more anterior (mean AP: operative, –2.8 mm, 95% confidence interval [CI] –5.0 to–0.7
vs healthy, –5.0 mm, 95% CI –6.7 to –3.2; P = .006) and lateral (mean ML: operative, 23.2 mm, 95% CI 21.9-24.5 vs healthy, 21.8
mm, 95% CI 20.2-23.3; P = .013) location. The CPs in the medial compartment were located significantly more
posterior (mean AP: operative, –3.4, 95% CI –5.0 to –1.9 vs healthy, –1.3, 95% CI
–2.6 to –0.1; P = .006) and lateral (mean ML: operative, –21.3, 95% CI –22.6 to –20.0 vs healthy,
–22.6, 95% CI –24.2 to –21.0; P = .021).
Conclusions
DB-ACLR restored the tibiofemoral cartilage contact mechanics to near-normal values
at 1-year follow-up. Adding the ALSA to the DB-ACLR resulted in significantly altered
tibiofemoral cartilage contact locations in both the medial and lateral compartments.
Clinical Relevance
In DB-ACLR knees, the addition of an ALSA may be unfavorable as it caused significantly
changed arthrokinematics.
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Article Info
Publication History
Published online: September 09, 2021
Accepted:
August 19,
2021
Received:
March 28,
2021
See commentary on page 1237Footnotes
The authors report the following potential conflicts of interest or sources of funding: supported by the National Key Research and Development Program of China (2018YFC1106202) and the Western Medicine Guidance Project of Science and Technology Commission of Shanghai Municipality, Grant No. 17411966400. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Jiayu Qiu and Cong Wang contributed equally to this work.
Identification
Copyright
© 2021 by the Arthroscopy Association of North America
