Increased ACL direct insertion coverage provided more positive biomechanical effects on graft and bone tunnel during knee flexion: a simulation study
Abstract Purpose Flattened femoral tunnels were recently applied in anatomical single‐bundle anterior cruciate ligament (ACL) reconstruction. Little is known about the biomechanical effect of such changes during knee flexion. The aim of the present simulation study was to assess the effect of altere...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-01-01
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| Series: | Journal of Experimental Orthopaedics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40634-023-00677-x |
| _version_ | 1827324283718729728 |
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| author | Yang Xiao Zhaoxin Liang Shiwen Shen Fei Liu Hai Hu Bin Chen |
| author_facet | Yang Xiao Zhaoxin Liang Shiwen Shen Fei Liu Hai Hu Bin Chen |
| author_sort | Yang Xiao |
| collection | DOAJ |
| description | Abstract Purpose Flattened femoral tunnels were recently applied in anatomical single‐bundle anterior cruciate ligament (ACL) reconstruction. Little is known about the biomechanical effect of such changes during knee flexion. The aim of the present simulation study was to assess the effect of altered ACL direct insertion coverage on the biomechanics of the graft and bone tunnel. Methods Five finite element (FE) models, including a round femoral tunnel and four progressively flattened rounded rectangular femoral tunnels, were established to represent the ACL reconstructions. In vivo knee kinematics data obtained from the validated dual fluoroscopic imaging techniques controlled the FE models to simulate lunge motions. The maximal principal stress of the graft and the volume of equivalent strain within 1000–3000 microstrain (V1000‐3000) of the cancellous bone were subsequently calculated at 0°, 30°, 60° and 90° of knee flexion. Results A lower stress state on the graft and a more beneficial strain state on the cancellous bone were observed when the femoral tunnel better covered the ACL direct insertion. The average maximal principal stress of each model were 3.93 ± 0.60 MPa, 3.82 ± 0.54 MPa, 3.43 ± 0.44 MPa, 3.45 ± 0.44 MPa and 3.05 ± 0.43 MPa, respectively. The average V1000‐3000 of the cancellous bone of each model were 179.06 ± 89.62 mm3, 221.40 ± 129.83 mm3, 247.57 ± 157.78 mm3, 282.74 ± 178.51 mm3 and 295.71 ± 162.59 mm3, respectively. Both the stress and strain values exhibited two peaks during the flexion simulation. The highest value occurred at 30° of flexion, and the second highest value occurred at 90° of flexion. Conclusions Increased ACL direct insertion coverage provided more positive biomechanical effects after anatomical single‐bundle ACL reconstruction during knee flexion. |
| first_indexed | 2024-04-25T02:10:13Z |
| format | Article |
| id | doaj.art-fa1a82e0c9cd44d393ffbbd7f27cba2b |
| institution | Directory Open Access Journal |
| issn | 2197-1153 |
| language | English |
| last_indexed | 2024-04-25T02:10:13Z |
| publishDate | 2023-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Experimental Orthopaedics |
| spelling | doaj.art-fa1a82e0c9cd44d393ffbbd7f27cba2b2024-03-07T12:46:42ZengWileyJournal of Experimental Orthopaedics2197-11532023-01-01101n/an/a10.1186/s40634-023-00677-xIncreased ACL direct insertion coverage provided more positive biomechanical effects on graft and bone tunnel during knee flexion: a simulation studyYang Xiao0Zhaoxin Liang1Shiwen Shen2Fei Liu3Hai Hu4Bin Chen5Division of Orthopaedics and TraumatologyDepartment of OrthopaedicsNanfang HospitalSouthern Medical UniversityGuangzhouChinaThe First Clinical College of Southern Medical UniversityGuangzhouChinaDivision of Orthopaedics and TraumatologyDepartment of OrthopaedicsNanfang HospitalSouthern Medical UniversityGuangzhouChinaDivision of Orthopaedics and TraumatologyDepartment of OrthopaedicsNanfang HospitalSouthern Medical UniversityGuangzhouChinaDepartment of Orthopedic Surgery and Orthopedic Biomechanical LaboratoryShanghai Jiao Tong University Affiliated Sixth People’s HospitalShanghaiChinaDivision of Orthopaedics and TraumatologyDepartment of OrthopaedicsNanfang HospitalSouthern Medical UniversityGuangzhouChinaAbstract Purpose Flattened femoral tunnels were recently applied in anatomical single‐bundle anterior cruciate ligament (ACL) reconstruction. Little is known about the biomechanical effect of such changes during knee flexion. The aim of the present simulation study was to assess the effect of altered ACL direct insertion coverage on the biomechanics of the graft and bone tunnel. Methods Five finite element (FE) models, including a round femoral tunnel and four progressively flattened rounded rectangular femoral tunnels, were established to represent the ACL reconstructions. In vivo knee kinematics data obtained from the validated dual fluoroscopic imaging techniques controlled the FE models to simulate lunge motions. The maximal principal stress of the graft and the volume of equivalent strain within 1000–3000 microstrain (V1000‐3000) of the cancellous bone were subsequently calculated at 0°, 30°, 60° and 90° of knee flexion. Results A lower stress state on the graft and a more beneficial strain state on the cancellous bone were observed when the femoral tunnel better covered the ACL direct insertion. The average maximal principal stress of each model were 3.93 ± 0.60 MPa, 3.82 ± 0.54 MPa, 3.43 ± 0.44 MPa, 3.45 ± 0.44 MPa and 3.05 ± 0.43 MPa, respectively. The average V1000‐3000 of the cancellous bone of each model were 179.06 ± 89.62 mm3, 221.40 ± 129.83 mm3, 247.57 ± 157.78 mm3, 282.74 ± 178.51 mm3 and 295.71 ± 162.59 mm3, respectively. Both the stress and strain values exhibited two peaks during the flexion simulation. The highest value occurred at 30° of flexion, and the second highest value occurred at 90° of flexion. Conclusions Increased ACL direct insertion coverage provided more positive biomechanical effects after anatomical single‐bundle ACL reconstruction during knee flexion.https://doi.org/10.1186/s40634-023-00677-xAnterior cruciate ligament reconstructionDirect insertionFemoral tunnelFinite element analysisBiomechanics |
| spellingShingle | Yang Xiao Zhaoxin Liang Shiwen Shen Fei Liu Hai Hu Bin Chen Increased ACL direct insertion coverage provided more positive biomechanical effects on graft and bone tunnel during knee flexion: a simulation study Journal of Experimental Orthopaedics Anterior cruciate ligament reconstruction Direct insertion Femoral tunnel Finite element analysis Biomechanics |
| title | Increased ACL direct insertion coverage provided more positive biomechanical effects on graft and bone tunnel during knee flexion: a simulation study |
| title_full | Increased ACL direct insertion coverage provided more positive biomechanical effects on graft and bone tunnel during knee flexion: a simulation study |
| title_fullStr | Increased ACL direct insertion coverage provided more positive biomechanical effects on graft and bone tunnel during knee flexion: a simulation study |
| title_full_unstemmed | Increased ACL direct insertion coverage provided more positive biomechanical effects on graft and bone tunnel during knee flexion: a simulation study |
| title_short | Increased ACL direct insertion coverage provided more positive biomechanical effects on graft and bone tunnel during knee flexion: a simulation study |
| title_sort | increased acl direct insertion coverage provided more positive biomechanical effects on graft and bone tunnel during knee flexion a simulation study |
| topic | Anterior cruciate ligament reconstruction Direct insertion Femoral tunnel Finite element analysis Biomechanics |
| url | https://doi.org/10.1186/s40634-023-00677-x |
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