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The Human Anterior Cruciate Ligament and Its Replacement: Biomechanical Considerations

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Biomechanics in Orthopedics

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Summary

The inability of a mid-substance tear of the anterior cruciate ligament (ACL) to heal often leads to surgical intervention to restore knee stability, but there is much debate on graft selection and reconstruction techniques. We believe that increased knowledge of the function of the ACL, such as its tensile properties and its role in maintaining knee kinematics, will provide the baseline data needed to improve surgical treatment regimens.

Tensile testing of the femur-ACL-tibia complex (FATC) from 27 donors (22 to 97 years) demonstrated significant reductions in stiffness and strength (p < 0.05) with age. Using a kinematic linkage system, the anteromedial (AM) portion of the ACL was found to lengthen and sustain a majority of the applied load with knee flexion, while the posterolateral (PL) portion lengthened and sustained applied load only during extension.

During ACL reconstruction, graft placement and initial tension both significantly affect joint kinematics and graft force. An increase in initial tension from 10N to 40N resulted in substantial increases in measured graft force. Quadriceps muscle force further increased the graft force, while conactivation of the hamstrings served to decrease graft force.

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Author information

Authors and Affiliations

  1. Connective Tissue and Musculoskeletal Research Laboratory Department of Orthopaedic Surgery, University of Pittsburgh, San Diego, USA

    Savio L-Y. Woo, Douglas J. Adams & Shinro Takai

  2. Orthopaedic Bioengineering Laboratory, University of California, San Diego, USA

    Savio L-Y. Woo, Douglas J. Adams & Shinro Takai

Authors
  1. Savio L-Y. Woo
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  2. Douglas J. Adams
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  3. Shinro Takai
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Editor information

Editors and Affiliations

  1. Department of Orthopedic Surgery, Aichi Medical University, 21 Yazako Karimata, 480-11, Nagakute, Aichi, Japan

    Shigeo Niwa M.D.  & Tomokazu Hattori BSC.  & 

  2. AO/ASIF Research Institute, Clavadelerstrasse, CH-7270, Davos Platz, Switzerland

    Stephan M. Perren DR. MED., DR. SC.(H.C.)

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© 1992 Springer-Verlag Tokyo

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Woo, S.LY., Adams, D.J., Takai, S. (1992). The Human Anterior Cruciate Ligament and Its Replacement: Biomechanical Considerations. In: Niwa, S., Perren, S.M., Hattori, T. (eds) Biomechanics in Orthopedics. Springer, Tokyo. https://doi.org/10.1007/978-4-431-68216-5_2

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  • DOI: https://doi.org/10.1007/978-4-431-68216-5_2

  • Publisher Name: Springer, Tokyo

  • Print ISBN: 978-4-431-68218-9

  • Online ISBN: 978-4-431-68216-5

  • eBook Packages: Springer Book Archive

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