Peak stresses shift from femoral tunnel aperture to tibial tunnel aperture in lateral tibial tunnel ACL reconstructions: a 3D graft-bending angle measurement and finite-element analysis
| Autor: | Jan Victor, Alexander Schepens, Wouter Devriendt, Hans Van Der Bracht, Peter Verdonk, Michiel Cromheecke, Thomas Tampere, Pieter Beekman |
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| Rok vydání: | 2017 |
| Předmět: |
musculoskeletal diseases
Knee Joint Anterior cruciate ligament reconstruction Aperture medicine.medical_treatment Anterior cruciate ligament Finite Element Analysis Tendons 03 medical and health sciences Imaging Three-Dimensional 0302 clinical medicine Cadaver medicine Humans Orthopedics and Sports Medicine Femur Tibia Range of Motion Articular Aged Orthodontics 030222 orthopedics Anterior Cruciate Ligament Reconstruction business.industry 030229 sport sciences musculoskeletal system Biomechanical Phenomena Prosthesis Failure Equipment Failure Analysis surgical procedures operative medicine.anatomical_structure Tissue Transplantation Surgery Cadaveric spasm business Tomography Spiral Computed |
| Zdroj: | Knee Surgery, Sports Traumatology, Arthroscopy. 26:508-517 |
| ISSN: | 1433-7347 0942-2056 |
| DOI: | 10.1007/s00167-017-4739-8 |
| Popis: | To investigate the effect of tibial tunnel orientation on graft-bending angle and stress distribution in the ACL graft. Eight cadaveric knees were scanned in extension, 45°, 90°, and full flexion. 3D reconstructions with anatomically placed anterior cruciate ligament (ACL) grafts were constructed with Mimics 14.12®. 3D graft-bending angles were measured for classic medial tibial tunnels (MTT) and lateral tibial tunnels (LTT) with different drill-guide angles (DGA) (45°, 55°, 65°, and 75°). A pivot shift was performed on 1 knee in a finite-element analysis. The peak stresses in the graft were calculated for eight different tibial tunnel orientations. In a classic anatomical ACL repair, the largest graft-bending angle and peak stresses are seen at the femoral tunnel aperture. The use of a different DGA at the tibial side does not change the graft-bending angle at the femoral side or magnitude of peak stresses significantly. When using LTT, the largest graft-bending angles and peak stresses are seen at the tibial tunnel aperture. In a classic anatomical ACL repair, peak stresses in the ACL graft are found at the femoral tunnel aperture. When an LTT is used, peak stresses are similar compared to classic ACL repairs, but the location of the peak stress will shift from the femoral tunnel aperture towards the tibial tunnel aperture. Clinical relevance: the risk of graft rupture is similar for both MTTs and LTTs, but the location of graft rupture changes from the femoral tunnel aperture towards the tibial tunnel aperture, respectively. I. |
| Databáze: | OpenAIRE |
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