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Journal of Bone and Joint Surgery - British Volume, Vol 83-B, Issue 8, 1098-1103.
doi: 10.1302/0301-620X.83B8.11320  
Copyright © 2001 by British Editorial Society of Bone and Joint Surgery
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Reconstruction does not reduce tibial translation in the cruciate-deficient knee

AN IN VIVO STUDY

D. J. Beard, DPhil, Senior Fellow1; D. W. Murray, FRCS, Professor of Orthopaedics1; H. S. Gill, DPhil, Senior Fellow1; A. J. Price, FRCS, Research Fellow1; J. L. Rees, FRCS, Research Fellow1; J. Alfaro-Adrián, FRCS, Orthopaedic Surgeon2; and C. A. F. Dodd, FRCS, Consultant Orthopaedic Surgeon1

1 Nuffield Orthopaedic Centre NHS Trust, Windmill Road, Headington, Oxford OX3 7LD, UK.
2 Clinica La Zarzuela, Departmento de Traumatologia, 28023 Aravaca, Madrid, Spain.

Correspondence should be sent to Dr D. J. Beard.

We have assessed the effectiveness of reconstruction of the anterior cruciate ligament (ACL) in reducing functional tibial translation (TT).

The gait of 11 ACL-deficient patients was studied using Vicon equipment before and after surgery. Measurements of the angle between the patellar tendon and the long axis of the tibia were obtained in order to calculate TT in the sagittal plane relative to the uninjured limb during standing and walking.

Before surgery, patients did not show abnormal TT on the injured side, but after surgery significant anterior TT was found in the operated limb for every parameter of gait.

Abnormal anterior TT occurring during activity does not seem to be reduced by reconstruction; rather, it increases. It may be that the increased translation results from relaxation of excess contraction of the hamstring muscles, since compensatory muscle activity no longer is required in a reconstructed knee. The reduction of TT may not be an appropriate objective in surgery on the ACL.




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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General