Each knee underwent kinematic testing by the Kuka robot in the following states: 1) Intact, 2) ACL reconstruction, 3) Segmental lateral meniscal root tear, 4) Lateral meniscal root repair, and 5) Lateral meniscal root repair augmented with meniscofemoral ligament imbrication. The order of states 4 and 5 was randomized, such that each procedure was performed first on half the specimens. ROM was tested on all specimens to ensure capability to perform all desired movements for the study. The ACL was re-tensioned to 88 N in full extension between each state after the ACL reconstruction state for consistency between states. Kinematic evaluation consisted of a total of eleven tests, performed in a randomized order. Five tests were performed at full extension and at 30° of knee flexion: 1) 88-N Anterior drawer, 2) 5-Nm Internal Rotation (IR), 3) 5-Nm External Rotation (ER), 4) 5-Nm Varus, and 5) 5-Nm Valgus. Additionally, a simulated pivot shift test, consisting of combined 5-Nm internal rotation, 5-Nm varus, and 88-N anterior load, was run at 30° of flexion [8 (link)]. The order of the tests was randomized to avoid confounding findings from one sequence of motion. All tests were performed at a fixed flexion angle, and a 20-N compressive load was applied to seat the joint. The forces and torques on the other axes were set to 0 N and 0 Nm, respectively. Tests were programmed to end when all forces were within 2 N of their targets and all torques were within 0.2 Nm of their targets for five consecutive seconds. Anterior tibial translation (ATT) was measured by the Kuka robot and reported in mm for the anterior drawer and simulated pivot shift tests, and knee range of motion was reported in degrees for the IR, ER, varus, and valgus tests. ACL Graft force was recorded during all tests.
Free full text: Click here
