Biomechanical Effects of Additional Anterolateral Structure Reconstruction With Different Femoral Attachment Sites on Anterior Cruciate Ligament Reconstruction

作者：Mai Katakura, Hideyuki Koga, Tomomasa Nakamura, Daisuke Araki, Kanto Nagai, Kyohei K. Nishida, Ryosuke Kuroda, Takeshi Muneta · 发表于：The American Journal of Sports Medicine · 年份：2019 · DOI：10.1177/0363546519880192 · 被引用次数：28 · 研究领域：Knee injuries and reconstruction techniques、Total Knee Arthroplasty Outcomes、Lower Extremity Biomechanics and Pathologies

BACKGROUND: Recently reported anterolateral structure reconstructions (ALSRs) to augment intra-articular anterior cruciate ligament reconstruction (ACLR) use various femoral attachment sites, and their biomechanical effects are still unknown. HYPOTHESIS: ALSR concomitant with ACLR would control anterolateral rotational instability better than ACLR alone, and if ALSR had different femoral attachment sites, there would be different effects on its control of anterolateral rotational instability. STUDY DESIGN: Controlled laboratory study. METHODS: Twelve fresh-frozen hemipelvis lower limbs were included. Anterior tibial translation during the Lachman test and tibial acceleration during the pivot-shift test were measured with a 3-dimensional electromagnetic measurement system in situations with the (1) ACL and ALS intact, (2) ACL and ALS cut, (3) ALSR without ACLR (ALSR alone), (4) ACLR without ALSR (ACLR alone), and (5) ALSR with ACLR. Three femoral attachment sites were used for ALSR: F1, 2 mm anterior and 2 mm distal to the lateral epicondyle; F2, 4 mm posterior and 8 mm proximal to the lateral epicondyle; and F3, over-the-top position for the lateral extra-articular tenodesis. The Steel test and Wilcoxon signed rank test were used for statistical analysis. RESULTS: = .046), although additional ALSR with F1 and F3 showed no significant effect. CONCLUSION: ALSR with the femoral attachment site 4 mm posterior and 8 mm proximal to the lateral epicondyle in addition to ACLR played ...