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POSTERIOR CRUCIATE LIGAMENT: STUDIES OF ONE AND TWO-BUNDLE RECONSTRUCTIONS

SHEARN, JASON T.

Abstract Details

2002, PhD, University of Cincinnati, Engineering : Engineering Mechanics.
The posterior cruciate ligament (PCL) is the primary restraint to posterior translation and is a secondary restraint to varus, valgus and external rotation.[12, 32, 43, 60] PCL injuries increase posterior translation and impair a person's ability to perform daily activities.[59, 67, 100] If left untreated, degenerative changes will appear earlier in the injured knee than in the contralateral knee.[17, 79, 82] A variety of surgical procedures have been used in an attempt to restore normal posterior translation. Some procedures have been unable to restore posterior translation,[48, 77, 111, 127] while others have been unable to maintain normal posterior translation[65, 85, 90]. The failure to control posterior translation has been attributed to graft elongation.[48, 81, 85] In an attempt to prevent graft elongation, two-bundle reconstructions have been investigated[65, 81, 119] and have shown promising initial results. However, the resistance to posterior translation is unknown. The purpose of this research was to investigate the ability of one and two-bundle PCL reconstructions to resist posterior translation during cyclic fatigue testing. The femoral attachment of the one-bundle graft and one bundle (AL2) of all two-bundle grafts were located within the PCL's anterolateral band, which is named for its anterior femoral insertion and its lateral tibial insertion. The second bundle was placed posterior to the AL2 bundle in one of three locations that varied in their depth within the notch: shallow (S), intermediate (I), and deep (D). The specimens were cycled from near full extension to 120 degrees of flexion with 100 N applied posterior force. The knees were cycled until the tension in both bundles was 50 N or less. The two-bundle reconstructions did not provide better resistance to posterior translation than the one-bundle reconstruction for a 2.5-mm posterior translation increase. The AL2-I reconstruction resisted the return of posterior translation for significantly more cycles than the one-bundle reconstruction, but the two-bundle reconstructions did not reduced the rate of posterior translation return as the posterior translation increased to 7.5 mm. However, the rate of return for the AL2-I reconstruction decreased as the posterior translation increased beyond 2.5 mm. This study did not provide a reconstruction that replicated the intact knee's resistance to posterior translation, but several areas were discovered that might lead to the improvement of current PCL reconstructions.
Dr. Edward S. Grood (Advisor)
177 p.

Recommended Citations

Citations

  • SHEARN, J. T. (2002). POSTERIOR CRUCIATE LIGAMENT: STUDIES OF ONE AND TWO-BUNDLE RECONSTRUCTIONS [Doctoral dissertation, University of Cincinnati]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1016486579

    APA Style (7th edition)

  • SHEARN, JASON. POSTERIOR CRUCIATE LIGAMENT: STUDIES OF ONE AND TWO-BUNDLE RECONSTRUCTIONS. 2002. University of Cincinnati, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=ucin1016486579.

    MLA Style (8th edition)

  • SHEARN, JASON. "POSTERIOR CRUCIATE LIGAMENT: STUDIES OF ONE AND TWO-BUNDLE RECONSTRUCTIONS." Doctoral dissertation, University of Cincinnati, 2002. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1016486579

    Chicago Manual of Style (17th edition)