Effect of femoral tunnel positions on graft stress in outside‐in ACL reconstruction surgery during continuous knee motion: A simulation study
Abstract
Background: Previous studies regarding the optimal femoral tunnel location for an anterior cruciate ligament (ACL) reconstruction were based on static experiments at specific angles, and did not consider continuous motion of the knee. Methods: Twenty‐four surgical sites were set and continuous kinematic data, obtained from motion analysis, was used to describe knee movement. The bending angle and stress of the ACL graft as well as the length of the femoral tunnel was calculated through multi‐flexible body dynamics analysis. Results: The lowest stress was found at both 5 mm and 10 mm radius at a proximal posterior of 45°, and the highest stress was also found at a distal 15 mm radius. Relatively high stresses were also identified between the distal and anterior regions as well as the distal and posterior regions at 15 mm radius. Conclusion: Considering the availability of surgery, it was identified that the optimum femoral tunnel location is at 10 mm radius locations at a proximal posterior of 45°.
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Large stresses on the graft and stresses close to the femoral or tibial tunnels are closely related to graft injuries and the widening of tunnels after surgery.
“Large stresses on the graft and stresses close to the femoral or tibial tunnels were thought to be closely related to graft injuries and the widening of tunnels after surgery [15, 32].”
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“Large stresses on the graft and stresses close to the femoral or tibial tunnels were thought to be closely related to graft injuries and the widening of tunnels after surgery [15, 32].”
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Self-citation
- Authors
- Kang, K., & Bae, T. S.
- Affiliations
- Jungwon University (KR)
- Corresponding author
- Bae, Tae Soo
- ORCID
- Bae, Tae Soo
- Venue
- The International Journal of Medical Robotics and Computer Assisted Surgery
- Publisher
- Wiley
- Published
- 2017-03-31
- Volume
- 13
- Issue
- 4
- ISSN
- 1478-5951 (ISSN-L)
- 1478-596X
- OpenAlex
- W2601187471
- Cited by
- 10
- References
- 24
- Citations by year
- 2024: 3 · 2023: 2 · 2022: 1 · 2021: 2 · 2020: 1 · 2019: 1
- FWCI
- 0.56
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Medical Robotics and Computer Assisted Surgery (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Ministry of Science, ICT and Future Planning (2013R1A1A1005740)
- Topics
- Health Sciences › Medicine › Surgery › Knee injuries and reconstruction techniques
- Physical Sciences › Engineering › Biomedical Engineering › Lower Extremity Biomechanics and Pathologies
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Tendon Structure and Treatment
- Keywords
- anterior cruciate ligament reconstruction, femoral tunnel placement, outside-in technique, knee kinematics, flexible body dynamics, tunnel radius
- MeSH terms
- Biomechanical Phenomena, Computer Simulation, Femur, Humans, Knee, Knee Joint, Motion, Tibia, Reproducibility of Results, Imaging, Three-Dimensional, Anterior Cruciate Ligament Reconstruction
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