TY - JOUR
T1 - Tibial rotation in anterior cruciate ligament (ACL)-deficient and ACL-reconstructed knees
T2 - A theoretical proposition for the development of osteoarthritis
AU - Stergiou, Nicholas
AU - Ristanis, Stavros
AU - Moraiti, Constantina
AU - Georgoulis, Anastasios D.
N1 - Funding Information:
Dr Stergiou has been supported by a Faculty Development Fellowship from the University of Nebraska, Omaha, USA. The authors also gratefully acknowledge the funding support from the General Secretariat for Research and Technology of the Ministry of Development, as well as the European Social Fund of EU. The authors have no conflicts of interest that are directly relevant to the content of this review.
PY - 2007
Y1 - 2007
N2 - Excessive tibial rotation has been documented in anterior cruciate ligament (ACL) deficiency during walking. ACL reconstruction has been unable to correct this abnormality in activities that are more demanding than walking and involve both anterior and rotational loading of the knee. These findings persist regardless of graft selection for the ACL reconstruction (bone-patellar tendon-bone or semitendinosus gracilis). Based on this research work, we propose a theoretical perspective for the development of osteoarthritis in both the ACL-deficient and the ACL-reconstructed knee. We propose that excessive tibial rotation will lead to abnormal loading of the cartilage areas that are not commonly loaded in the healthy knee. Over time, this abnormal loading will lead to osteoarthritis. We hypothesise that the development of new surgical procedures and grafts, such as a more horizontally oriented femoral tunnel or a double-bundle ACL reconstruction, could possibly restore tibial rotation to normal levels and prevent future knee pathology. However, in vivo gait analysis studies are needed to examine the effects of these surgical procedures on tibial rotation. Prospective in vivo and in vitro studies are also necessary to verify or refute our theoretical proposition for the development of osteoarthritis.
AB - Excessive tibial rotation has been documented in anterior cruciate ligament (ACL) deficiency during walking. ACL reconstruction has been unable to correct this abnormality in activities that are more demanding than walking and involve both anterior and rotational loading of the knee. These findings persist regardless of graft selection for the ACL reconstruction (bone-patellar tendon-bone or semitendinosus gracilis). Based on this research work, we propose a theoretical perspective for the development of osteoarthritis in both the ACL-deficient and the ACL-reconstructed knee. We propose that excessive tibial rotation will lead to abnormal loading of the cartilage areas that are not commonly loaded in the healthy knee. Over time, this abnormal loading will lead to osteoarthritis. We hypothesise that the development of new surgical procedures and grafts, such as a more horizontally oriented femoral tunnel or a double-bundle ACL reconstruction, could possibly restore tibial rotation to normal levels and prevent future knee pathology. However, in vivo gait analysis studies are needed to examine the effects of these surgical procedures on tibial rotation. Prospective in vivo and in vitro studies are also necessary to verify or refute our theoretical proposition for the development of osteoarthritis.
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U2 - 10.2165/00007256-200737070-00004
DO - 10.2165/00007256-200737070-00004
M3 - Review article
C2 - 17595155
AN - SCOPUS:34347380707
SN - 0112-1642
VL - 37
SP - 601
EP - 613
JO - Sports Medicine
JF - Sports Medicine
IS - 7
ER -