Double-bundle posterior cruciate ligament reconstruction: a biomechanical analysis of simulated early motion and partial and full weightbearing on common reconstruction grafts.

Autor: Mook WR; Steadman Philippon Research Institute, Vail, CO, 81657, USA.; The Steadman Clinic, 181 West Meadow Drive, Suite 400, Vail, CO, USA., Civitarese D; Steadman Philippon Research Institute, Vail, CO, 81657, USA., Turnbull TL; Steadman Philippon Research Institute, Vail, CO, 81657, USA., Kennedy NI; Steadman Philippon Research Institute, Vail, CO, 81657, USA., O'Brien L; Howard Head Sports Medicine Center, Vail, CO, USA., Schoeberl JB; The Steadman Clinic, 181 West Meadow Drive, Suite 400, Vail, CO, USA., LaPrade RF; Steadman Philippon Research Institute, Vail, CO, 81657, USA. drlaprade@sprivail.org.; The Steadman Clinic, 181 West Meadow Drive, Suite 400, Vail, CO, USA. drlaprade@sprivail.org.
Jazyk: angličtina
Zdroj: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA [Knee Surg Sports Traumatol Arthrosc] 2017 Aug; Vol. 25 (8), pp. 2536-2544. Date of Electronic Publication: 2016 Mar 21.
DOI: 10.1007/s00167-016-4056-7
Abstrakt: Purpose: The purpose of this study was to determine the biomechanical effects of simulated immediate motion and weightbearing during rehabilitation on different double-bundle posterior cruciate ligament reconstruction (DB-PCLR) graft options.
Methods: Nine each of commercially prepared (allograft) Achilles tendon allografts, fresh-frozen (autograft) bone-patellar tendon-bone grafts, and fresh-frozen quadriceps tendon grafts were paired with commercially prepared anterior tibialis allografts, fresh-frozen semitendinosus grafts, and fresh-frozen semitendinosus grafts, respectively. Graft pairs were loaded to simulate early range of motion on a stationary bicycle, partial weightbearing (30 %), and full weightbearing.
Results: Acquired laxity (displacement, mm) between graft pairs was not significantly different during simulated early range of motion. However, during simulated partial weightbearing, the median acquired laxity of the patellar tendon/semitendinosus pair (1.06 mm) was significantly less than that of the quadriceps tendon/semitendinosus (1.50 mm, p = 0.01) and Achilles/anterior tibialis (1.44 mm, p = 0.003) graft pairs. During simulated full weightbearing, significantly less acquired laxity was observed for the patellar tendon/semitendinosus graft pair (2.38 mm) compared to the Achilles/anterior tibialis pair (4.85 mm, p = 0.04), but a significant difference was not observed compared to the QT/semitendinosus graft pair (3.91 mm, n.s.). There were no significant differences in the ultimate loads between any of the graft pairs.
Conclusions: Simulated early range of motion and early partial weightbearing did not result in clinically significant acquired graft laxity in common graft options utilized for DB-PCLR. However, simulated full weightbearing did result in clinically significant acquired graft laxity, and therefore, early rehabilitation protocols should avoid implementing full weightbearing that could contribute to graft failure.
Databáze: MEDLINE
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