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Analysis of Isometry of the Anterior Cruciate Ligament for Optimal Ligament Reconstruction

전방십자인대의 최적 재건을 위한 등장성 해석

  • 박정홍 (부산대학교 기계설계대학원) ;
  • 서정탁 (부산대학교 의과대학 정형외과) ;
  • 문병영 (부산대학교 동남권부품소재 산학협력혁신사업단) ;
  • 손권 (부산대학교 기계공학부)
  • Published : 2006.04.01

Abstract

The anterior cruciate ligament (ACL) is liable to a major injury that often results in a functional impairment requiring surgical reconstruction. The success of reconstruction depends on such factors as attachment positions, initial tension of ligament and surgical methods of fixation. The purpose of this study is to find isometric positions of the substitute during flexion/extension. The distance between selected attachments on the femur and tibia was computed from a set of measurements using a 6 degree-of-freedom magnetic sensor system. A three-dimensional knee model was constructed from CT images and was used to simulate length change during knee flexion/extension. This model was scaled for each subject. Twenty seven points on the tibia model and forty two points on the femur model were selected to calculate length change. This study determined the maximum and minimum distances to the tibial attachment during flexion/extension. The results showed that minimum length changes were $1.9{\sim}5.8mm$ (average $3.6{\pm}1.4mm$). The most isometric region was both the posterosuperior and anterior-diagonal areas from the over-the-top. The proposed method can be utilized and applied to an optimal reconstruction of ACL deficient knees.

Keywords

Anterior Cruciate Ligament;Flexion-Extension;Knee Joint;Ligament Reconstruction;Isometry

References

  1. Girgis, F. G., Marshall, J. L. and Al Monajem, A. R. S., 1975, 'Cruciate Ligaments of the Knee Joint: Anatomical, Functional and Experimental Analysis,' Clinical Orthopaedics and Related Research, No. 106, pp. 216-231
  2. Arnoczky, S. P., 1983, 'Anatomy of the Anterior Cruciate Ligament,' Clinical Orthopeadics and Related Research, No. 172, pp. 19-25
  3. Odenstein, M. and Gillquist, J., 1985, 'Functional Anatomy of the Anterior Cruciate Ligament and a Rationale for Reconstruction,' Journal of Bone and Joint Surgery, Vol. 67-A, pp. 257-262 https://doi.org/10.2106/00004623-198567020-00012
  4. Anderson, A. F., Dome, D. C., Gautam, S., Awh, M. H. and Rennirt, G. W., 2001, 'Correlation of Anthropometric Measurements, Strength, Anterior Cruciate Ligament Size, and Intercondylar Notch Characteristics to Sex Differences in Anterior Cruciate Ligament Tear Rates,' The American Journal of Sports Medicine, Vol. 29, No. 1, pp. 58-66 https://doi.org/10.1177/03635465010290011501
  5. Piziali, R. L., Seering, W. P., Nagel, D. A. and Schurman, D. J., 1980, 'The Function of the Primary Ligaments of the Knee in Anterior-posterior and Medial-lateral Motions,' Journal of Biomechanics, Vol. 13, pp. 777-784 https://doi.org/10.1016/0021-9290(80)90239-0
  6. Woo, S. L-Y., Debski, R. E., Withrow, J. D. and Janaushek, M. A., 1999, 'Biomechanics of Knee Ligaments,' American Orthopaedic Society for Sports Medicine, Vol. 27, No. 4, pp. 533-543 https://doi.org/10.1177/03635465990270042301
  7. Blacharski, P. A., Somerset, J. H. and Murray, D. G., 1975, 'A Three-dimensional Study of the Kinematics of the Human Knee,' Journal of Biomechanics, Vol. 8, pp. 375-384 https://doi.org/10.1016/0021-9290(75)90073-1
  8. van Dijk, R., Huiskes, R. and Selvik, G., 1979, 'Roentgen Stereophotogrammetric Methods for the Evaluation of the Three Dimensional Kinematic Behaviour and Cruciate Ligament Length Patterns of the Human Knee Joint,' Journal of Biomechanics, Vol. 12, pp. 727-731 https://doi.org/10.1016/0021-9290(79)90021-6
  9. Fu, F. H., Bennett, C. H., Lattermann, C. and Ma C. B., 1999, 'Current Trends in Anteriror Cruciate Ligament Reconstruction,' The American Journal of Sports Medicine, Vol. 27, No. 6, pp. 821-830 https://doi.org/10.1177/03635465990270062501
  10. Park, K. B., Kim, K. B., Son, K., Suh, J. T. and Moon, B. Y., 2004, 'Construction and Measurement of Three-dimensional Knee Joint Model of Koreans,' Trans. of KSME(A), Vol. 28, No. 11, pp. 1664-1671 https://doi.org/10.3795/KSME-A.2004.28.11.1664
  11. Hefzy M. S., Grood E. S. and Noyes F. R., 1988, 'Factors Affecting the Region of Most Isometric Femoral Attachments: Part II: The Anterior Cruciate Ligament,' The American Journal of Sports Medicine, Vol. 17, No. 2, pp. 208-216 https://doi.org/10.1177/036354658901700210
  12. Veselko, M. and Godler, I., 2000, 'Biomechanical Study of a Computer Simulated Reconstruction of the Anterior Cruciate Ligament(ACL),' Computers in Biology and Medicine, No. 30, pp. 299-309 https://doi.org/10.1016/S0010-4825(00)00016-0
  13. Sidles, J. A., Larson, R. V., Joseph, G. L., Downey, D. J. and Matsen III, F. A., 1988, 'Ligament Length Relationships in the Moving Knee,' Journal of Orthopaedic Research, No. 6, pp. 593-610 https://doi.org/10.1002/jor.1100060418
  14. Hame, S. L., Markolf, K. L., Hunter, D. M., Oakes, D. A. and Zoric, B., 2003, 'Effects of Notchplasty and Femoral Tunnel Position on Excursion Patterns of an Anterior Cruciate Ligament Graft,' The Journal of Arthroscopic and Related Surgery, Vol. 19, No. 4, pp. 340-345 https://doi.org/10.1053/jars.2003.50040
  15. Markolf, K. L., Hame, S., Hunter, D. M., Oakes, D. A., Zoric, B., Gause, P. and Finerman, G. A. M., 2002, 'Effects of Femoral Tunnel Placement on Knee Laxity and Forces in an Anterior Cruciate Ligament Graft,' Journal of Orthopaedic Research, No. 20, pp. 1016-1024 https://doi.org/10.1016/S0736-0266(02)00035-9