| Ligament rupture is a frequent clinical problem with a rising annual incidence. Approximately 95000 new ligament ruptures, including anterior (ACL) and posterior cruciate ligament (PCL) ruptures, combined with ruptures of the postero-lateral corner (PLC), are diagnosed every year.; Our hypothesis is that to adequately restore knee function, not only knee laxity but also three-dimensional (3D) knee kinematics, must be repaired.; The goal of this work was, therefore, to acquire better knowledge on the effect of dissection and different types of reconstructions of the cruciate ligaments in 3D knee kinematics of cadaver knees.; We conducted two studies. The first series on 10 cadaver specimens dealt with PCL and PLC reconstruction. After isolated PCL dissection, double bundle and “over-the-bottom” methods were performed successively on each knee using synthetic polyester ligaments (LARS and TREVIRA respectively). The results of this study showed that both reconstruction methods were similar in restoring A-P laxity, with functional reconstruction needing 70 N pretension to be efficient.; On the same 10 cadaver knees, we then performed dissection of the posterolateral corner (PLC) structures, leaving the lateral collateral ligament (LCL) intact. Laxity results showed that combined reconstruction was necessary to restore initial rotatory knee laxity, but at the same time, it created non-physiologic internal rotation during the entire flexion/extension movement. This phenomenon was visible only on kinematic curves.; The second series of 10 other cadaver knees dealt with ACL reconstruction. Our results suggest that the “over-the-top” reconstruction performed here with dorso-medial placement of the tibial tunnel allows A-P laxity to be restored to a level near that of the intact knee. The two tunnel reconstructions, performed either with a prosthesis or a biological graft, adequately restored knee A-P laxity. (Abstract shortened by UMI.)... |
