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• W2939313368 abstract "Anterior cruciate ligament (ACL) graft conditioning protocols to decrease postoperative increases in anterior tibial translation and pivot-shift instability have not been established.To determine what ACL graft conditioning protocols should be performed at surgery to decrease postoperative graft elongation after ACL reconstruction.Controlled laboratory study.A 6 degrees of freedom robotic simulator evaluated 3 ACL graft constructs in 7 cadaver knees for a total of 19 graft specimens. Knees were tested before and after ACL sectioning and after ACL graft conditioning protocols before reconstruction. The ACL grafts consisted of a 6-strand semitendinosus-gracilis TightRope, bone-patellar tendon-bone TightRope, and bone-patellar tendon-bone with interference screws. Two graft conditioning protocols were used: (1) graft board tensioning (20 minutes, 80 N) and (2) cyclic conditioning (5°-120° of flexion, 90-N anterior tibial load) after graft reconstruction to determine the number of cycles needed to obtain a steady state with no graft elongation. After conditioning, the grafts were cycled a second time under anterior-posterior loading (100 N, 25° of flexion) and under pivot-shift loading (100 N anterior, 5-N·m internal rotation, 7 N·m valgus) to verify that the ACL flexion-extension conditioning protocol was effective.Graft board tensioning did not produce a steady-state graft. Major increases in anterior tibial translation occurred in the flexion-extension graft-loading protocol at 25° of flexion (mean ± SD: semitendinosus-gracilis TightRope, 3.4 ± 1.1 mm; bone-patellar tendon-bone TightRope, 3.2 ± 1.0 mm; bone-patellar tendon-bone with interference screws, 2.4 ± 1.5 mm). The second method of graft conditioning (40 cycles, 5°-120° of flexion, 90-N anterior load) produced a stable conditioned state for all grafts, as the anterior translations of the anterior-posterior and pivot-shift cycles were statistically equivalent ( P < .05, 1-20 cycles).ACL graft board conditioning protocols are not effective, leading to deleterious ACL graft elongations after reconstruction. A secondary ACL graft conditioning protocol of 40 flexion-extension cycles under 90-N graft loading was required for a well-conditioned graft, preventing further elongation and restoring normal anterior-posterior and pivot-shift translations.There is a combined need for graft board tensioning and robust cyclic ACL graft loading before final graft fixation to restore knee stability." @default.
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• W2939313368 date "2019-04-15" @default.
• W2939313368 modified "2023-10-10" @default.
• W2939313368 title "Anterior Cruciate Ligament Graft Conditioning Required to Prevent an Abnormal Lachman and Pivot Shift After ACL Reconstruction: A Robotic Study of 3 ACL Graft Constructs" @default.
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• W2939313368 doi "https://doi.org/10.1177/0363546519835796" @default.
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