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Journal of Bone and Joint Surgery - British Volume, Vol 88-B, Issue 3, 324-330.
doi: 10.1302/0301-620X.88B3.16787  
Copyright © 2006 by British Editorial Society of Bone and Joint Surgery
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Does anterior cruciate ligament reconstruction restore normal knee kinematics?

A PROSPECTIVE MRI ANALYSIS OVER TWO YEARS

J. M. Scarvell, PhD, Physiotherapist, University Lecturer1; P. N. Smith, FRACS, Associate Professor1; K. M. Refshauge, PhD, Professor2; H. R. Galloway, FRANZCR, Associate Professor Radiology, Director Medical Imaging3; and K. R. Woods, FRACS, Orthopaedic Surgeon4

1 Orthopaedic Surgery, Trauma and Orthopaedic Research Unit, 12A The Canberra Hospital, Yamba Drive, Garran ACT 2605, Australia.
2 School of Physiotherapy, University of Sydney, East Street, Lidcombe, New South Wales 2141, Australia.
3 ANU Medical School, Australian National University, The Canberra Hospital, Garran ACT 2605, Australia.
4 Canberra Orthopaedic Group, John James Hospital, ACT 2600, Australia.

Correspondence should be sent to Dr J. M. Scarvell; e-mail: jennie.scarvell{at}canberra.edu.au

This prospective study used magnetic resonance imaging to record sagittal plane tibiofemoral kinematics before and after anterior cruciate ligament reconstruction using autologous hamstring graft. Twenty patients with anterior cruciate ligament injuries, performed a closed-chain leg-press while relaxed and against a 150 N load. The tibiofemoral contact patterns between 0° to 90° of knee flexion were recorded by magnetic resonance scans. All measurements were performed pre-operatively and repeated at 12 weeks and two years.

Following reconstruction there was a mean passive anterior laxity of 2.1 mm (SD 2.3), as measured using a KT 1000 arthrometer, and the mean Cincinnati score was 90 (SD 11) of 100. Pre-operatively, the medial and lateral contact patterns of the injured knees were located posteriorly on the tibial plateau compared with the healthy contralateral knees (p = 0.014), but were no longer different at 12 weeks (p = 0.117) or two years postoperatively (p = 0.909). However, both reconstructed and healthy contralateral knees showed altered kinematics over time. At two years, the contact pattern showed less posterior translation of the lateral femoral condyle during flexion (p < 0.01).






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