The Elongation Behavior of the Anterior Cruciate Ligament Graft in Vivo: A Long-Term Follow-Up Study
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-to-side 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 anterior-posterior 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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A nonisometric graft can be expected to slacken during a large portion of the flexion cycle and to not prevent anterior translation.
“A nonisometric graft can be expected to slacken during a large portion of the flexion cycle and to not prevent anterior translation [28].”
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“A nonisometric graft can be expected to slacken during a large portion of the flexion cycle and to not prevent anterior translation [28].”
Background
- Authors
- Beynnon, B. D., Uh, B. S., Johnson, R. J., Fleming, B. C., Renström, P. A., & Nichols, C. E.
- Affiliations
- University of Vermont (US)
- Karolinska University Hospital (SE)
- Venue
- The American Journal of Sports Medicine
- Publisher
- SAGE Publications
- Published
- 2001-03
- Volume
- 29
- Issue
- 2
- Pages
- 161-166
- ISSN
- 0363-5465 (ISSN-L)
- 1552-3365
- OpenAlex
- W2148565119
- Cited by
- 60
- References
- 14
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 3 · 2022: 2 · 2021: 4 · 2020: 1 · 2019: 1 · 2018: 2 · 2017: 6 · 2016: 3 · 2015: 2 · 2014: 1 · 2013: 4
- FWCI
- 1.98
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Journal of Sports Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (5 T32 AR 07568, T32AR007568)
- Topics
- Health Sciences › Medicine › Surgery › Knee injuries and reconstruction techniques
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Tendon Structure and Treatment
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Foot and Ankle Surgery
- Keywords
- anterior cruciate ligament reconstruction, graft elongation, knee laxity, graft biomechanics, long-term follow-up, Hall effect transducers, KT-1000 arthrometer
- MeSH terms
- Adult, Biomechanical Phenomena, Female, Follow-Up Studies, Humans, Joint Instability, Male, Postoperative Complications, Tendons, Time Factors, Transplantation, Autologous, Bone Transplantation, Anterior Cruciate Ligament, Statistics, Nonparametric
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