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Yañez R, Silvestre R, Roby M, Neira A, Azar C, Madera S, Ortiz-Bernardin A, Carpes FP, De la Fuente C. Finite element graft stress for anteromedial portal, transtibial, and hybrid transtibial femoral drillings under anterior translation and medial rotation: an exploratory study. Sci Rep 2024; 14:11922. [PMID: 38789542 PMCID: PMC11126698 DOI: 10.1038/s41598-024-61061-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 04/30/2024] [Indexed: 05/26/2024] Open
Abstract
Stress concentration on the Anterior Cruciate Ligament Reconstruction (ACLr) for femoral drillings is crucial to understanding failures. Therefore, we described the graft stress for transtibial (TT), the anteromedial portal (AM), and hybrid transtibial (HTT) techniques during the anterior tibial translation and medial knee rotation in a finite element model. A healthy participant with a non-medical record of Anterior Cruciate Ligament rupture with regular sports practice underwent finite element analysis. We modeled TT, HTT, AM drillings, and the ACLr as hyperelastic isotropic material. The maximum Von Mises principal stresses and distributions were obtained from anterior tibial translation and medial rotation. During the anterior tibia translation, the HTT, TT, and AM drilling were 31.5 MPa, 34.6 Mpa, and 35.0 MPa, respectively. During the medial knee rotation, the AM, TT, and HTT drilling were 17.3 MPa, 20.3 Mpa, and 21.6 MPa, respectively. The stress was concentrated at the lateral aspect of ACLr,near the femoral tunnel for all techniques independent of the knee movement. Meanwhile, the AM tunnel concentrates the stress at the medial aspect of the ACLr body under medial rotation. The HTT better constrains the anterior tibia translation than AM and TT drillings, while AM does for medial knee rotation.
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Affiliation(s)
- Roberto Yañez
- Biomechanics unit, Innovation centre, MEDS clinic, Santiago, Chile
- Orthopaedic knee service, MEDS clinic, Santiago, Chile
| | - Rony Silvestre
- Biomechanics unit, Innovation centre, MEDS clinic, Santiago, Chile
| | - Matias Roby
- Biomechanics unit, Innovation centre, MEDS clinic, Santiago, Chile
- Orthopaedic knee service, MEDS clinic, Santiago, Chile
| | - Alejandro Neira
- Escuela de Kinesiologia, Facultad de Medicina y Ciencias de la Salud, Universidad Mayor, Santiago, Chile
| | - Camilo Azar
- Orthopaedic knee service, MEDS clinic, Santiago, Chile
| | - Samuel Madera
- Ingenieria Civil Mecanica, Facultad de Igenieria, Universidad de Chile, Santiago, Chile
| | | | - Felipe P Carpes
- Laboratory of Neuromechanics, Universidade Federal do Pampa, Uruguaiana, Brazil
| | - Carlos De la Fuente
- Exercise and Rehabilitation Sciences Institute, Postgraduate, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, RM, Chile.
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Trams E, Kulinski K, Pomianowski S, Kaminski R, Kozar-Kaminska K. Author Reply to "Regarding 'Repair Augmentation of Unstable, Complete Vertical Meniscal Tears With Bone Marrow Venting Procedure: A Prospective, Randomized, Double-Blind, Parallel-Group, Placebo-Controlled Study'". Arthroscopy 2022; 38:2594-2596. [PMID: 36064271 DOI: 10.1016/j.arthro.2022.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 06/17/2022] [Indexed: 02/02/2023]
Affiliation(s)
- Ewa Trams
- Department of Orthopaedics and Trauma Surgery, Centre of Postgraduate Medical Education, Gruca Orthopaedic and Trauma Teaching Hospital, Konarskiego, Poland
| | - Krzysztof Kulinski
- Department of Orthopaedics and Trauma Surgery, Centre of Postgraduate Medical Education, Gruca Orthopaedic and Trauma Teaching Hospital, Konarskiego, Poland
| | - Stanislaw Pomianowski
- Department of Orthopaedics and Trauma Surgery, Centre of Postgraduate Medical Education, Gruca Orthopaedic and Trauma Teaching Hospital, Konarskiego, Poland
| | - Rafal Kaminski
- Department of Orthopaedics and Trauma Surgery, Centre of Postgraduate Medical Education, Gruca Orthopaedic and Trauma Teaching Hospital, Konarskiego, Poland
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