2023 ISAKOS Biennial Congress ePoster
Comparison Of Lateral Tibiofemoral Joint Contact Pressure In Lateral Extra-Articular Tenodesis Tensioned In Neutral Tibial Rotation And External Tibial Rotation: A Biomechanical Study
Napatpong Thamrongskulsiri, MD, Bangkok THAILAND
Thun Itthipanichpong, MD, Bangkok THAILAND
Danaithep Limskul, MD, Bangkok THAILAND
Somsak Kuptniratsaikul, MD, Pathumwan, Bangkok THAILAND
Thanathep Tanpowpong, MD, Bangkok THAILAND
Faculty of Medicine, Chulalongkorn University, Bangkok, THAILAND
FDA Status Not Applicable
Summary
The peak contact pressure of the lateral tibiofemoral joint is higher in lateral extra-articular tenodesis which is tension in external rotation than in neutral rotation.
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Abstract
Background
Lateral extra-articular tenodesis (LET) is a procedure performed to increase rotational stability in patients with high-risk anterior cruciate ligament (ACL) graft failure. Early methods of LET were performed by tensioning grafts in tibial external rotation to control internal tibial rotation and pivot shifting, but this can result in over-constraint of lateral tibiofemoral joint. The purpose of this study was to determine the mean contact pressure, peak contact pressure, and mean contact area of the lateral tibiofemoral joint in LET knee with tension on the graft in tibial neutral rotation and external rotation.
Methods
Eight Thiel’s embalmed cadaveric knees were prepared and divided into 2 groups (4 knees in each group); (1) LET-NR (tension in neutral rotation), (2) LET-ER (tension in external rotation). Each knee was prepared by the corresponding technique. The E10000 Instron simulates an axial load of 735 N (equivalent to a 75 kg person standing one-leg standing) for 10 seconds in each group.
Results
LET-ER group shows significantly higher peak contact pressure (1,235.5 kPa vs 702.3 kPa, P = .010). There is no significant difference in mean contact pressure or mean contact area between the two groups.
Conclusions
The peak contact pressure of the lateral tibiofemoral joint is higher in LET which is tension in external rotation than in neutral rotation. As the result, LET tension in neutral rotation might be employed for ACL reconstruction augmentation to prevent over-constrain of the lateral tibiofemoral joint.