ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2018
Stress distribution is deviated around the aperture of the femoral tunnel in the anatomic anterior cruciate ligament reconstruction.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
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Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Delayed versus Accelerated Weight-bearing Rehabilitation Protocol Following Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis.Journal of rehabilitation medicine · 2022Pooled it
- Pooled it
- Effects of Graft Bending Angle on the Tensile Behavior of Bone Tunnel-Graft Constructs for Anterior Cruciate Ligament Reconstruction Using Bone-Patellar Tendon-Bone Graft.Bioengineering (Basel, Switzerland) · 2026Article
- Gradual stabilization and narrowing of bone tunnels following primary anterior cruciate ligament reconstruction.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Article
- Proximally positioned femoral grafts decrease passive anterior tibial subluxation in anterior cruciate ligament reconstruction using a posterior trans-septal portal.International orthopaedics · 2024Article
- Anterior cruciate ligament femoral side retained stump technique reduces enlargement of the femoral bone tunnel after anterior cruciate ligament reconstruction.BMC musculoskeletal disorders · 2024Article
- A non-weight bearing protocol after ACL reconstruction improves static anterior tibial translation in patients with elevated slope and increased weight bearing tibial anterior translation.Journal of experimental orthopaedics · 2023Article
- Eccentrically widened bone tunnels after all-inside anterior cruciate ligament reconstruction: a computed tomography and three-dimensional model-based analysis.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- Article
- Intra-Articular Biomechanical Changes of the Meniscus and Ligaments During Stance Phase of Gait Circle after Different Anterior Cruciate Ligament Reconstruction Surgical Procedures: A Finite Element Analysis.Orthopaedic surgery · 2022Article
- Effects of modified trans-tibial versus trans-portal technique on stress patterns around the femoral tunnel in anatomical single-bundle ACL reconstruction with different knee flexion angles using finite element analysis.BMC musculoskeletal disorders · 2022Article
- Gender-Based Quantitative Analysis of the Grand Piano Sign in Mechanically Aligned Total Knee Arthroplasty in Asians.Journal of clinical medicine · 2021Article
- Creating a Femoral Tunnel Aperture at the Anteromedial Footprint Versus the Central Footprint in ACL Reconstruction: Comparison of Contact Stress Patterns.Orthopaedic journal of sports medicine · 2021Article
- Anatomic Differences in the Sagittal Knee Joint Are Associated With ACL Injury: Results From a Skeletally Immature Korean Population.Orthopaedic journal of sports medicine · 2021Article
- Medio-Lateral and Flexion-Extension Gap Imbalances in Mechanically Aligned Total Knee Arthroplasty Using Measured Resection Technique in Korean Patients: 3D Simulation.Journal of clinical medicine · 2021Article
- Gender difference exists in sagittal curvature of the distal femoral condyle morphology for osteoarthritic population.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2020Article
- Femoral trochlear morphology is associated with anterior cruciate ligament injury in skeletally immature patients.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2020Article
- Effect of the presence of the articular cartilage on the femoral component rotation in total knee arthroplasty in female and varus osteoarthritis knees.Journal of orthopaedic surgery and research · 2020Article
- Stiffness and shape of the ACL graft affects tunnel enlargement and graft wear.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2020Article
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeFinal tunnel location in the anterior cruciate ligament (ACL) reconstruction is unpredictable due to tunnel widening and/or transposition. The mechanical stress around the tunnel aperture seems to be a major factor but is not fully investigated. The purpose of this study was to measure the stress from the ACL graft around the tunnel aperture when the ACL graft tension reaches its peak.
methodsSix cadaveric knees were used. Single-bundle ACL reconstruction was performed using a hamstrings graft. Both femoral and tibial tunnels were created at the centre of the original ACL footprint. A 7-mm-internal-diameter aluminium cylinder with pressure sensors was placed in the femoral tunnel. Hamstrings graft with a microtension sensor was inserted. After fixation, passive extension-flexion was performed while monitoring the tunnel aperture pressure and the graft tension simultaneously. The pressure on the femoral tunnel aperture when the ACL graft tension reach its peak was compared between four directions.
resultsThe ACL graft tension peaked (67 ± 49 N) at full extension (-5.8 ± 4.1°). Pressure at the femoral tunnel aperture was different between different directions (p < 0.01). Distal part had significantly larger pressure (1.7 ± 1.3 MPa) than the other directions (p < 0.01). Second largest pressure was carried in the anterior part (0.6 ± 0.5 MPa), followed by proximal and posterior parts (0.4 ± 0.3, 0.2 ± 0.2 MPa respectively).
conclusionThe stress distribution at the femoral tunnel aperture is not equal in different directions, while the distal part dominantly bears the stress from the ACL graft. Surgeons should pay close attention to the distal edge of the femoral tunnel which should be inside the anatomic ACL footprint eventually.
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