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Document Title: Beynnon-AJSM-Mar01
Article Title: The elongation behavior of the anterior cruciate ligament graft in vivo
Authors: Bruce D. Beynnon, Benjamin S. Uh, Robert J. Johnson, Brandon C. Fleming, et al.
Publication: The American Journal of Sports Medicine
ISSN: 03635465
Date: March-April 2001.
(Figures included. Reference-denoting numbers appear in the same point size as document text.)
Volume: 29
Issue: 2
Pages: 161-166
Key Words: Knee, sports medicine, sports injuries, surgeries, ligaments, reconstruction.
This article documents the medium-term (5 years post-op) behaviour of patellar-tendon grafts.
ABSTRACT
The relationship between the elongation values of an autogenous bone-patellar tendon-bone graft immediately after fixation and the anterior-posterior laxity of the knee 5 years later was studied in vivo. Immediately after fixation, the change in the graft midsubstance length during passive knee flexion-extension was measured using a Hall-effect transducer, and anterior-posterior knee laxity was measured with the KT-1000 arthrometer. Subjects were divided into group 1 (N = 6), with graft elongation values bounded by the 95% confidence intervals of the normal anterior cruciate ligament elongation values, and group 2 (N = 7), subjects with values outside these intervals. Immediately after reconstruction, the side-toside difference in anterior-posterior laxity between the reconstructed and uninjured knees was not different between group 1 (-2.6 +/- 0.7 mm, mean +/-SEM) and group 2 (-1.7 +/-1.0 mm) (P = 0.49). At 5-year follow-up, the difference was 1.2 +/- 0.7 mm for group 1, while for group 2 it was significantly greater at 4.7 +/- 0.6 mm (P = 0.004). At surgery, graft elongation values produced by flexion of the knee that are outside the limits of the anterior cruciate ligament result in significant increases in anterior knee laxity at long-term follow-up, while grafts with elongation values similar to the normal anterior cruciate ligament do not. Not only is restoration of anteriorposterior laxity values to within normal limits important, but the biomechanical behavior of the graft produced by flexion-extension of the knee should be appreciated.
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