PURPOSE: This study evaluated knee laxity in anterior tibial translation and rotation following removal of anterior cruciate ligament (ACL) remnants using a computer navigation system. METHODS: This prospective study included 50 knees undergoing primary ACL reconstruction using a navigation system. ACL remnants were classified into four morphologic types: Type 1, bridging between the roof of the intercondylar notch and tibia; Type 2, bridging between the posterior cruciate ligament and tibia; Type 3, bridging between the anatomical insertions of the ACL on the lateral wall of the femoral condyle and the tibia; and Type 4, no bridging of ACL remnants. Anterior tibial translation and rotatory laxity were measured before and after remnant resection using a navigation system at 30°, 60°, and 90° of knee flexion. The amount of change in anterior tibial translation and rotatory laxity of each type was compared among the types. RESULTS: The different morphologic types of ACL remnants were as follows: Type 1, 15 knees; Type 2, 9 knees; Type 3, 6 knees; and Type 4, 20 knees. The amount of change in anterior tibial translation and rotatory laxity at 30° knee flexion in Type 3 was significantly larger than in the other types. There were no significant differences in either tibial translation or rotatory laxity at 60° and 90° knee flexion among the types. CONCLUSIONS: In Type 3, ACL remnants contributed to anteroposterior and rotatory knee laxity evaluated at 30° knee flexion. The bridging point of the remnants is important to knee laxity. The Type 3 remnant should be preserved as much as possible when ACL reconstruction surgery is performed. LEVEL OF EVIDENCE: Prognostic study, level II.
PURPOSE: This study evaluated knee laxity in anterior tibial translation and rotation following removal of anterior cruciate ligament (ACL) remnants using a computer navigation system. METHODS: This prospective study included 50 knees undergoing primary ACL reconstruction using a navigation system. ACL remnants were classified into four morphologic types: Type 1, bridging between the roof of the intercondylar notch and tibia; Type 2, bridging between the posterior cruciate ligament and tibia; Type 3, bridging between the anatomical insertions of the ACL on the lateral wall of the femoral condyle and the tibia; and Type 4, no bridging of ACL remnants. Anterior tibial translation and rotatory laxity were measured before and after remnant resection using a navigation system at 30°, 60°, and 90° of knee flexion. The amount of change in anterior tibial translation and rotatory laxity of each type was compared among the types. RESULTS: The different morphologic types of ACL remnants were as follows: Type 1, 15 knees; Type 2, 9 knees; Type 3, 6 knees; and Type 4, 20 knees. The amount of change in anterior tibial translation and rotatory laxity at 30° knee flexion in Type 3 was significantly larger than in the other types. There were no significant differences in either tibial translation or rotatory laxity at 60° and 90° knee flexion among the types. CONCLUSIONS: In Type 3, ACL remnants contributed to anteroposterior and rotatory knee laxity evaluated at 30° knee flexion. The bridging point of the remnants is important to knee laxity. The Type 3 remnant should be preserved as much as possible when ACL reconstruction surgery is performed. LEVEL OF EVIDENCE: Prognostic study, level II.
Authors: Anthony M Buoncristiani; Fotios P Tjoumakaris; James S Starman; Mario Ferretti; Freddie H Fu Journal: Arthroscopy Date: 2006-09 Impact factor: 4.772
Authors: A D Georgoulis; L Pappa; U Moebius; V Malamou-Mitsi; S Pappa; C O Papageorgiou; N J Agnantis; P N Soucacos Journal: Knee Surg Sports Traumatol Arthrosc Date: 2001-09-07 Impact factor: 4.342
Authors: C Mouton; D Theisen; T Meyer; H Agostinis; C Nührenbörger; D Pape; R Seil Journal: Knee Surg Sports Traumatol Arthrosc Date: 2015-08-30 Impact factor: 4.342
Authors: S Zaffagnini; F Urrizola; C Signorelli; A Grassi; T Roberti Di Sarsina; G A Lucidi; G M Marcheggiani Muccioli; T Bonanzinga; M Marcacci Journal: Knee Surg Sports Traumatol Arthrosc Date: 2016-10-15 Impact factor: 4.342