The effect of an inclined landing surface on biomechanical variables during a jumping task
Document Actions
A prospectively randomized double-blind study on the effect of initial graft tension on knee stability after anterior cruciate ligament reconstruction
by
Nicholas SJ, D'Amato MJ, Mullaney MJ, Tyler TF, Kolstad K, McHugh MP.
—
last modified
2009-10-09 15:17
Am J Sports Med. 2004 Dec;32(8):1881-6.
BACKGROUND: No consensus exists on the amount of tension that should be applied
to anterior cruciate ligament grafts to best facilitate graft incorporation and
re-create normal knee mechanics. HYPOTHESIS: Differences in initial graft tension
will affect postoperative knee stability. STUDY DESIGN: Prospective, randomized,
double-blind clinical trial. METHODS: Forty-nine patients undergoing
bone-patellar tendon-bone autograft anterior cruciate ligament reconstruction by
a single surgeon were randomized into high-tension (n = 27) and low-tension (n =
22) groups. Grafts were set at 90 N or 45 N. Arthrometric measurements (KT-1000
arthrometer manual maximum) of anterior tibial displacement and knee range of
motion were made before surgery and at 1 week and an average of 20 months after
surgery. Knee outcome scores were collected before and after surgery, and a
single-leg hop test was also performed at final follow-up. RESULTS: After
anterior cruciate ligament reconstruction, anterior tibial displacement was
significantly greater in the patients in the low-tension group (P < .05). The
side-to-side difference in anterior tibial displacement in the high-tension and
low-tension groups was 1.1 +/- 1.7 mm versus 2.4 +/- 2.4 mm 1 week after surgery
and 2.2 +/- 1.6 mm versus 3.0 +/- 2.2 mm at follow-up. Five patients had abnormal
anterior tibial displacement (>5 mm side-to-side difference), and all were in the
low-tension group (P < .05). Knee outcome scores improved with surgery (P < .01),
with similar results for low-tension and high-tension groups. Hop test deficits
were not different between groups. CONCLUSIONS: Initial graft tension affects the
restoration of knee stability. A graft tension of 45 N was not sufficient for
restoring knee stability.