PhD, University of Cincinnati, 2002, Engineering : Engineering Mechanics
The posterior cruciate ligament (PCL) is the primary restraint to posterior translation and is a secondary restraint to varus, valgus and external rotation.[12, 32, 43, 60] PCL injuries increase posterior translation and impair a person's ability to perform daily activities.[59, 67, 100] If left untreated, degenerative changes will appear earlier in the injured knee than in the contralateral knee.[17, 79, 82] A variety of surgical procedures have been used in an attempt to restore normal posterior translation. Some procedures have been unable to restore posterior translation,[48, 77, 111, 127] while others have been unable to maintain normal posterior translation[65, 85, 90]. The failure to control posterior translation has been attributed to graft elongation.[48, 81, 85] In an attempt to prevent graft elongation, two-bundle reconstructions have been investigated[65, 81, 119] and have shown promising initial results. However, the resistance to posterior translation is unknown. The purpose of this research was to investigate the ability of one and two-bundle PCL reconstructions to resist posterior translation during cyclic fatigue testing. The femoral attachment of the one-bundle graft and one bundle (AL2) of all two-bundle grafts were located within the PCL's anterolateral band, which is named for its anterior femoral insertion and its lateral tibial insertion. The second bundle was placed posterior to the AL2 bundle in one of three locations that varied in their depth within the notch: shallow (S), intermediate (I), and deep (D). The specimens were cycled from near full extension to 120 degrees of flexion with 100 N applied posterior force. The knees were cycled until the tension in both bundles was 50 N or less. The two-bundle reconstructions did not provide better resistance to posterior translation than the one-bundle reconstruction for a 2.5-mm posterior translation increase. The AL2-I reconstruction resisted the return of posterior translation for significantl (open full item for complete abstract)
Committee: Dr. Edward S. Grood (Advisor)
Subjects: Engineering, Biomedical