In this section
@article{Lord:2019:10.1016/j.arthro.2019.01.058,
author = {Lord, BR and El-Daou, H and Zdanowicz, U and Smigielski, R and Amis, AA},
doi = {10.1016/j.arthro.2019.01.058},
journal = {ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY},
pages = {2101--2111},
title = {The role of fibers within the tibial attachment of the anterior cruciate ligament in restraining tibial displacement},
url = {http://dx.doi.org/10.1016/j.arthro.2019.01.058},
volume = {35},
year = {2019}
}
TY - JOUR
AB - PurposeTo evaluate the load-bearing functions of the fibers of the anterior cruciate ligament (ACL) tibial attachment in restraining tibial anterior translation, internal rotation, and combined anterior and internal rotation laxities in a simulated pivot-shift test.MethodsTwelve knees were tested using a robot. Laxities tested were: anterior tibial translation (ATT), internal rotation (IR), and coupled translations and rotations during a simulated pivot-shift. The kinematics of the intact knee was replayed after sequentially transecting 9 segments of the ACL attachment and fibers entering the lateral gutter, measuring their contributions to restraining laxity. The center of effort (COE) of the ACL force transmitted to the tibia was calculated. A blinded anatomic analysis identified the densest fiber area in the attachment of the ACL and thus its centroid (center of area). This centroid was compared with the biomechanical COE.ResultsThe anteromedial tibial fibers were the primary restraint of ATT (84% across 0° to 90° flexion) and IR (61%) during isolated and coupled displacements, except for the pivot-shift and ATT in extension. The lateral gutter resisted 28% of IR at 90° flexion. The anteromedial fibers showed significantly greater restraint of simulated pivot-shift rotations than the central and posterior fibers (P < .05). No significant differences (all <2 mm) were found between the anatomic centroid of the C-shaped attachment and the COE under most loadings.ConclusionsThe peripheral anteromedial fibers were the most important area of the ACL tibial attachment in the restraint of tibial anterior translation and internal rotation during isolated and coupled displacements. These mechanical results matched the C-shaped anteromedial attachment of the dense collagen fibers of the ACL.Clinical RelevanceThe most important fibers in restraining tibial displacements attach to the C-shaped anteromedial area of the native ACL tibial attachment. This findi
AU - Lord,BR
AU - El-Daou,H
AU - Zdanowicz,U
AU - Smigielski,R
AU - Amis,AA
DO - 10.1016/j.arthro.2019.01.058
EP - 2111
PY - 2019///
SN - 0749-8063
SP - 2101
TI - The role of fibers within the tibial attachment of the anterior cruciate ligament in restraining tibial displacement
T2 - ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY
UR - http://dx.doi.org/10.1016/j.arthro.2019.01.058
UR - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000473264200030&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR - https://www.sciencedirect.com/science/article/pii/S0749806319301550?via%3Dihub
UR - http://hdl.handle.net/10044/1/77080
VL - 35
ER -
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