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Article

Graft Diameter Should Reflect the Size of the Native Anterior Cruciate Ligament (ACL) to Improve the Outcome of ACL Reconstruction: A Finite Element Analysis

School of Biomedical Engineering and Engineering Research Center for Digital Medicine of the Ministry of Education, Shanghai Jiao Tong University, Shanghai 200030, China
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Author to whom correspondence should be addressed.
Bioengineering 2022, 9(10), 507; https://doi.org/10.3390/bioengineering9100507
Submission received: 13 September 2022 / Revised: 24 September 2022 / Accepted: 25 September 2022 / Published: 27 September 2022

Abstract

The size of the anterior cruciate ligament (ACL) often varies between individuals, but such variation is not typically considered during ACL reconstruction (ACLR). This study aimed to explore how the size of the ACL affects the selection of a suitable graft diameter. A finite element model of a human knee was implanted with intact ACLs of different dimensions (0.95, 1 and 1.05 times the size of the original ACL) and with grafts of different diameters, to simulate ACLR (diameter 7.5–12 mm in 0.5 mm increments). The knee models were flexed to 30° and loaded with an anterior tibial load of 103 N, internal tibial moment of 7.5 Nm, and valgus tibial moment of 6.9 Nm. Knee kinematics (anterior tibial translation (ATT), internal tibial rotation (ITR) and valgus tibial rotation (VTR)) and ligament forces were recorded and compared among the different groups. The results showed that, compared with the intact knee, a graft diameter of 7.5 mm was found to increase the ATT and VTR, but reduce the graft force. Increasing the graft diameter reduced knee laxity and increased the graft force. A 10% increase in the size of the ACL corresponded to a 3 mm larger graft diameter required to restore knee stability and graft force after ACLR. It was concluded that the graft diameter should be selected according to the dimensions of the native ACL, for better restoration of knee functionality. This study may help to improve the clinical treatment of ACL ruptures.
Keywords: anterior cruciate ligament reconstruction (ACLR); graft diameter; graft force; knee stability anterior cruciate ligament reconstruction (ACLR); graft diameter; graft force; knee stability
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MDPI and ACS Style

Wang, H.; Tao, M.; Shi, Q.; He, K.; Cheng, C.-K. Graft Diameter Should Reflect the Size of the Native Anterior Cruciate Ligament (ACL) to Improve the Outcome of ACL Reconstruction: A Finite Element Analysis. Bioengineering 2022, 9, 507. https://doi.org/10.3390/bioengineering9100507

AMA Style

Wang H, Tao M, Shi Q, He K, Cheng C-K. Graft Diameter Should Reflect the Size of the Native Anterior Cruciate Ligament (ACL) to Improve the Outcome of ACL Reconstruction: A Finite Element Analysis. Bioengineering. 2022; 9(10):507. https://doi.org/10.3390/bioengineering9100507

Chicago/Turabian Style

Wang, Huizhi, Mingzhu Tao, Qinyi Shi, Kaixin He, and Cheng-Kung Cheng. 2022. "Graft Diameter Should Reflect the Size of the Native Anterior Cruciate Ligament (ACL) to Improve the Outcome of ACL Reconstruction: A Finite Element Analysis" Bioengineering 9, no. 10: 507. https://doi.org/10.3390/bioengineering9100507

APA Style

Wang, H., Tao, M., Shi, Q., He, K., & Cheng, C.-K. (2022). Graft Diameter Should Reflect the Size of the Native Anterior Cruciate Ligament (ACL) to Improve the Outcome of ACL Reconstruction: A Finite Element Analysis. Bioengineering, 9(10), 507. https://doi.org/10.3390/bioengineering9100507

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