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research-article

A Novel Graft Fixation Technique for ACL Reconstruction Using Hamstring Tendon Grafts

[+] Author and Article Information
Guoan Li

Orthopaedic Biomechanics Lab Department of Orthopaedic Surgery Newton-Wellesley Hospital/Harvard Medical School Newton, MA
gli1@partners.org

Ali Hosseini

Orthopaedic Biomechanics Lab Department of Orthopaedic Surgery Newton-Wellesley Hospital/Harvard Medical School Newton, MA
AHOSSEINI@PARTNERS.ORG

Hemanth Gadikota

Orthopaedic Biomechanics Lab Department of Orthopaedic Surgery Newton-Wellesley Hospital/Harvard Medical School Newton, MA
hemanthgadikota@gmail.com

Thomas J. Gill

Orthopaedic Biomechanics Lab Department of Orthopaedic Surgery Newton-Wellesley Hospital/Harvard Medical School Newton, MA
tgill@partners.org

1Corresponding author.

ASME doi:10.1115/1.4038307 History: Received April 26, 2017; Revised October 09, 2017

Abstract

This study evaluated the biomechanical efficacy of single tunnel double bundle ACL reconstruction technique. The graft construct is achieved using a novel fixation device that splits an ACL (SPACL) graft into two bundles, recreating the anteromedial and posterolateral bundles for ACL reconstruction. A pullout strength test of the SPACL was performed using a 7mm bovine digital extensor tendon graft. The capability in restoration of knee kinematics after SPACL reconstruction was investigated using cadaveric human knees on a robotic testing system under an anterior tibial load of 134N and a simulated quadriceps load of 400N. The data indicated that the SPACL graft has a pullout strength of 823.7±172.3N. Under the 134N anterior tibial load, the anteroposterior joint laxity had increased constraint using the SPACL reconstruction but not significantly (p>0.05) at all selected flexion angles. Under the 400N quadriceps load, no significant differences were observed between the anterior tibial translation of intact knee and SPACL conditions at all selected flexion angles, but the SPACL graft induced a significant increase in external tibial rotation compared to the intact knee condition at all selected flexion angles with a maximal external rotation of -3.20°±3.6° at 90° flexion. These data showed that the SPACL technique is equivalent or superior to existing ACL reconstruction techniques in restoration of knee laxity and kinematics. The new SPACL reconstruction technique could provide a valuable alternation to contemporary ACL reconstruction surgery by more closely recreating native ACL kinematics.

Copyright (c) 2017 by ASME
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