caa a22 4500 605458480 CHVBK 20210128100229.0 cr unu---uuuuu 210128e20151001xx s 000 0 eng 10.1007/s00167-014-3418-2 doi (NATIONALLICENCE)springer-10.1007/s00167-014-3418-2 Intraoperative laxity measurements using a navigation system in anatomical double-bundle posterior cruciate ligament reconstruction [Elektronische Daten] [Yuka Kimura, Eiichi Tsuda, Yasuharu Hiraga, Yuji Yamamoto, Shugo Maeda, Yasuyuki Ishibashi] Purpose: The objective of this study was to evaluate knee kinematics during double-bundle posterior cruciate ligament reconstruction (DB-PCLR) intraoperatively using a navigation system, and especially assess biomechanical behaviour of the anterolateral bundle (ALB) and posteromedial bundle (PMB) graft in DB-PCLR. Also, clinical results of minimum 2-year follow-up were investigated. Methods: Nine patients received DB-PCLR with hamstring graft. Before reconstruction, knee laxities, including posterior tibial translation (PTT) in neutral rotation at 15°, 30°, 45°, 60°, 75° and 90° of knee flexion, were measured using a kinematic-based navigation system. After the PMB or ALB was temporally fixed, the knee laxities were measured in the same manner. Each patient was evaluated pre- and post-operatively with side-to-side difference of tibial position in gravity sag view and Lysholm score. Results: Both ALB and PMB fixation restrained the PTT compared to PCL deficiency throughout all knee flexion angles. At 90° of knee flexion, ALB fixation significantly decreased PTT compare to PMB fixation (p=0.014) and DB-PCLR significantly decreased PTT compare to ALB fixation (p=0.045). The mean side-to-side difference of tibial position in gravity sag view was 12.0±1.7mm preoperatively and 2.3±1.8mm at final follow-up, and the mean Lysholm scores were 68.9±20.9 and 96.3±2.9, respectively. Conclusions: There were no significant differences in the PTT between ALB and PMB fixations at 0° to 75° of knee flexion, and both ALB and PMB reconstructions are important for restraining PTT. At 90° of knee flexion, the ALB grafts may be more important to control PTT compared to PMB grafts; however, neither single-bundle reconstruction with ALB nor PMB could function as DB-PCLR did. In addition, PTT after DB-PCLR was strongly correlated side-to-side difference in posterior sag view at the final follow-up. The results from this study indicated that both ALB and PMB are important to stabilize PCL-deficient knees. Level of evidence: Therapeutic study, Level III. European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA), 2014 Posterior cruciate ligament (PCL) nationallicence Double-bundle reconstruction nationallicence Navigation system nationallicence Anterolateral bundle nationallicence Posteromedial bundle nationallicence Kimura Yuka Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Zaifu-cho 5, 036-8562, Hirosaki, Japan aut Tsuda Eiichi Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Zaifu-cho 5, 036-8562, Hirosaki, Japan aut Hiraga Yasuharu Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Zaifu-cho 5, 036-8562, Hirosaki, Japan aut Yamamoto Yuji Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Zaifu-cho 5, 036-8562, Hirosaki, Japan aut Maeda Shugo Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Zaifu-cho 5, 036-8562, Hirosaki, Japan aut Ishibashi Yasuyuki Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Zaifu-cho 5, 036-8562, Hirosaki, Japan aut Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/10(2015-10-01), 3085-3093 0942-2056 23:10<3085 2015 23 167 https://doi.org/10.1007/s00167-014-3418-2 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00167-014-3418-2 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Kimura Yuka Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Zaifu-cho 5, 036-8562, Hirosaki, Japan aut NATIONALLICENCE 700 1- Tsuda Eiichi Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Zaifu-cho 5, 036-8562, Hirosaki, Japan aut NATIONALLICENCE 700 1- Hiraga Yasuharu Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Zaifu-cho 5, 036-8562, Hirosaki, Japan aut NATIONALLICENCE 700 1- Yamamoto Yuji Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Zaifu-cho 5, 036-8562, Hirosaki, Japan aut NATIONALLICENCE 700 1- Maeda Shugo Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Zaifu-cho 5, 036-8562, Hirosaki, Japan aut NATIONALLICENCE 700 1- Ishibashi Yasuyuki Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Zaifu-cho 5, 036-8562, Hirosaki, Japan aut NATIONALLICENCE 773 0- Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/10(2015-10-01), 3085-3093 0942-2056 23:10<3085 2015 23 167