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INTRODUCTION
Anterior cruciate ligament rupture is a common
injury.
However, controversy still exists regarding the
best surgical technique, graft choice and graft
fixation.
The forces transmitted through the ACL vary
based on the integrity of the menisci, the other
knee ligaments, and the position of the knee.
Brand and coworkers [1] demonstrated ACL
loads during daily activities (Table 1).
Noyes and coworkers [2] have estimated that
the ACL strength needed for most activities
was 454 N. Therefore, the initial fixation
strength of an ACL graft required for these
activities should be greater than 450 N.
It is well recognized that graft fixation is the
weakest link in the early postoperative period
after ACL reconstruction.
GRAFT FIXATION
Graft fixation must be strong enough to avoid
failure, stiff enough to restore load displacement
response and allow biological incorporation of
the graft into the bone tunnels and secure
enough to resist slippage under cyclic loading.
It should also be reproducible, biocompatible,
MRI possible and easy to revise.
GRAFT FIXATION
J. CHAPPUIS, J. BARTH, J.C. PANISSET
Table 1:
From Brand and coworkers [1]
Activities
ACL (N)
PCL (N)
Level Walking
169
352
Ascending stairs
67
641
Descending stairs
445
262
Descending ramp
93
449
Ascending ramp
27
1215