Abstract
The posterolateral (PL) graft experiences a high failure rate in anterior cruciate ligament double-bundle (DB) reconstruction. It is hypothesized that tunnel positions could dramatically affect the graft forces. A validated computational model was used to simulate DB reconstruction with various femoral PL tunnel locations (8-11mm center-center tunnel spacing). Graft fixation was simulated at both 0° and 30°. Knee biomechanics were examined with the knee under a 134N anterior load and 400N quadriceps load at 0°, 30°, 60°, and 90° of flexion. Graft forces, tibial translation, and tibial rotation were calculated. PL graft forces at full extension increased with increasing tunnel spacing under both fixation settings, but the knee kinematics was not dramatically affected. Small changes in the femoral PL tunnel position could result in large changes in graft forces, implying that precise PL tunnel position is an important factor in a successful DB reconstruction.
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