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Anterior cruciate ligament replacement. Knee stability and the effects of implants



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Abstract

The anteroposterior stability of cadaveric knees was investigated. There was a wide range of normal laxity; knees were more stable at 90 degrees than at 20 degrees flexion. Anterior cruciate ligament implants with different stiffnesses were inserted; normal stability could always be restored, and the stiffness or extensibility of implants did not affect knee behaviour significantly. The tightness of implants was critical--small tensioning errors caused subluxation, inhibited knee extension and allowed damagingly high implant tensions. It is concluded that the tension of ligament implants could not be adjusted simply with a pre-set instrument; the procedure will remain critically dependent on the judgment of the operating surgeon.

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