Technical considerations in lateral extra-articular reconstruction coupled with anterior cruciate ligament reconstruction: A simulation study evaluating the influence of surgical parameters on control of knee stability

Autor: J. A. de Guise, Mathieu Thaunat, Adnan Saithna, Bertrand Sonnery-Cottet, Yoann Blache, Raphaël Dumas
Přispěvatelé: Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM ), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet [Saint-Étienne] (UJM)-Université Savoie Mont Blanc (USMB [Université de Savoie] [Université de Chambéry]), Laboratoire de Biomécanique et Mécanique des Chocs (LBMC UMR T9406), Université de Lyon-Université de Lyon-Institut Français des Sciences et Technologies des Transports, de l'Aménagement et des Réseaux (IFSTTAR), Laboratoire de recherche en imagerie et orthopédie [Montréal] (LIO), Ecole de Technologie Supérieure [Montréal] (ETS)-Centre Hospitalier de l'Université de Montréal (CHUM), Université de Montréal (UdeM)-Université de Montréal (UdeM), Advanced Orthopedics and Sports Medicine, Centre Orthopédique Santy-Group Ramsay-Générale de Santé, Hôpital privé Jean Mermoz
Rok vydání: 2018
Předmět:
musculoskeletal diseases
Adult
Joint Instability
Male
GRAFT TENSION AT SURGERY
Anterior cruciate ligament reconstruction
Knee Joint
Rotation
medicine.medical_treatment
Anterior cruciate ligament
Biophysics
Femoral attachment
BIOMECANIQUE
03 medical and health sciences
Fixation (surgical)
0302 clinical medicine
FEMORAL ATTACHMENT SITE
Medicine
Humans
Orthopedics and Sports Medicine
Computer Simulation
Knee
GENOU
Full extension
Femur
Graft fixation
Range of Motion
Articular
Orthodontics
Anterior Cruciate Ligament Reconstruction
Tibia
business.industry
Anterior Cruciate Ligament Injuries
[SPI.MECA.BIOM]Engineering Sciences [physics]/Mechanics [physics.med-ph]/Biomechanics [physics.med-ph]
TIBIAL ATTACHMENT SITE
030229 sport sciences
musculoskeletal system
Biomechanical Phenomena
SIMULATED PIVOT-SHIFT
medicine.anatomical_structure
ANTERIOR-CRUCIATE LIGAMENT
KNEE FLEXION AT SURGERY
business
Epicondyle
030217 neurology & neurosurgery
Zdroj: Clinical Biomechanics
Clinical Biomechanics, Elsevier, 2019, 61, pp. 136-143. ⟨10.1016/j.clinbiomech.2018.12.011⟩
ISSN: 1879-1271
0268-0033
Popis: Background: Surgical parameters such as the selection of tibial and femoral attachment site, graft tension, and knee flexion angle at the time of fixation may influence the control of knee stability after lateral extra-articular reconstruction. This study aimed to determine how sensitive is the control of knee rotation and translation, during simulated pivot-shift scenarios, to these four surgery settings.\ud \ud Methods: A computer model was used to simulate 625 lateral extra-articular reconstructions based upon five different variations of each of the following parameters: femoral and tibial attachment sites, knee flexion angle and graft tension at the time of fixation. For each simulated surgery, the lateral extra-articular reconstruction external rotation moment at the knee joint center was computed during simulated pivot-shift scenarios. The sensitivity of the control of knee rotation and translation to a given surgery setting was assessed by calculating the coefficient of variation of the lateral extra-articular reconstruction external rotation moment.\ud \ud Findings: Graft tension had minimal influence on the control of knee rotation and translation with less than 2.4% of variation across the scenarios tested. Control of knee rotation and translation was the least affected by the femoral attachment site if the knee was close to full extension at the time of graft fixation. The choice of the tibial attachment site was crucial when the femoral fixation was proximal and posterior to the femoral epicondyle since 15 to 67% of variation was observed in the control of knee rotation and translation.\ud \ud Interpretation: Femoral and tibial attachment sites as well as knee flexion angle at the time of fixation should be considered by surgeons when performing lateral extra-articular reconstruction. Variation in graft tension between the ranges 20–40 N has minimal influence on the control of knee rotation and translation.
Databáze: OpenAIRE
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