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30
shown by being tight in extension and in
internal rotation at 20 and then relaxed with the
knee going to exion at 120 and during internal
rotation at 90. Previous work exploring extra-
articular lateral tenodesis highlights the
importance of an isometric, anatomic
reconstruction to avoid complications such as
postoperative stiffness, excessive constraint of
internal tibial rotation, and alteration of
kinematics. Maximizing ROM while providing
a competent ALL reconstruction is crucial for
post-operative success.
This was scientifically tested in part two of the
in vitro robotic assessment with special
attention to a combined reconstruction of the
ALL and ACL [6]. In this study, the ALL
reconstruction was able to further reduce the
knee laxity when tested in conjunction with an
ACL reconstruction. A primary finding was
that during a simulated pivot-shift test, a
significant reduction in internal rotation at 30°,
45°, and 60° of knee flexion was noted for the
ACL reconstruction in conjunction with an
ALL reconstruction. This was statistically
significant when compared to the ACL
reconstruction with deficient ALL testing state.
CONCLUSION
The future of biomechanical testing should
include previously validated methodology,
adequate sample size, and clinically
translational study groups. Biomechanical
optimization of surgical techniques can only go
a certain extent to impact patient outcomes due
to the primary limitation of time-zero study
design. Therefore, proposed techniques should
be objectively monitored in clinical cohort
studies to examine the positive effects that
have arisen from their biomechanical data.
LITERATURE
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