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BIOMECHANICAL EVALUATION OF AN INNOVATIVE DOUBLE BUNDLE SURGICAL TECHNIQUE FOR THE RECONSTRUCTION OF ANTERIOR CRUCIATE LIGAMENT



Abstract

Aims: The experimental application and biomechanical evaluation of a double – bundle ACL reconstructive technique(Ä plasty)

Methods: The reported technique suggests use of a pair of grafts, with common origin and different insertions. Experimental surgery was conducted on 25 porcine knee joints, divided as follows: Group A of 15 joints for the reported technique and group B of 10 joints for a single – bundle technique. Group A was divided in subgroups A1, A2 and A3, depending on different distances between insertion points. For surgery and testing a device was designed, with adaptors serving specimen alignment adjustments. A dial gauge was used for monitoring displacements caused by simulated drawer tests. Tests were carried out at knee flexion angles of 30, 60 and 90 degrees and with the natural ACL intact, ruptured and reconstructed. Measurements of Knee laxity were recorded

Results: In the intact condition, no statistical difference was found between specimens used to compare the two techniques (p-value equals 0,905). Overall, the double – bundle technique provided significantly lower laxity values, than the one – bundle technique (2.0 plus/minus 0.6 mm and 3.4 plus/minus 0.9 mm, respectively, with p – value less than 0.001). Laxity values obtained with the double – bundle technique were significantly lower, when adopting a large distance between insertions (p – value equals 0.016).

Conclusions: As the two techniques were compared on a uniform specimen population, results of in vitro biomechanical testing advocate that the reported double- bundle technique offered ACL reconstructions of superior stability. This is a promising technique which is deserved biggest study in vivo.

The abstracts were prepared by Eleni Koutsoukou. Correspondence should be addressed to him at the Hellenic Association of Orthopaedic Surgery and Traumatology (HAOST), 20, A. Fleming str, 15123 Marousi, Athens, Greece.