Graft tensioning during knee ligament reconstruction: principles and practice

J Am Acad Orthop Surg. 2012 Oct;20(10):633-45. doi: 10.5435/JAAOS-20-10-633.

Abstract

Failure to correctly tension grafts may overconstrain or underconstrain the knee, potentially predisposing the patient to deteriorating clinical and/or radiographic results over time. Knee ligament reconstruction requires a fundamental understanding of native anatomy, ligament biomechanics, and principles of graft tensioning. A successful strategy for graft tensioning takes into account the specific biomechanics of the ligament or ligaments in question, the mechanical properties of the graft selected, the chosen fixation method, the selected tensioning method (ie, manual or mechanical), and the overall goal of the reconstruction (ie, isometry versus anisometry).

Publication types

  • Review

MeSH terms

  • Anterior Cruciate Ligament Reconstruction / instrumentation*
  • Anterior Cruciate Ligament Reconstruction / methods*
  • Biomechanical Phenomena
  • Bone-Patellar Tendon-Bone Grafting*
  • Humans
  • Knee Injuries / surgery*
  • Ligaments, Articular / injuries*
  • Ligaments, Articular / surgery*
  • Plastic Surgery Procedures / methods
  • Tendon Transfer / methods*