ANTERIOR CRUCIATE LIGAMENT GRAFT TENSIONING IN FULL EXTENSION

The purpose of this study was to determine anterior laxity and graft f orces in cadaveric knees after anterior cruciate ligament reconstructi on in which the graft is tensioned with the knee in full extension. We also analyzed the clinical results from a series of patients who had ligament reconstructions using this technique. We performed anterior c ruciate ligament reconstructions on seven fresh cadaveric knees and th en measured the anterior laxity, graft set force, and graft tension. W e also did a prospective minimum 2-year followup on 57 patients who un derwent anterior cruciate ligament reconstruction. The in vitro data s howed average anterior laxity of 1.1 mm greater than the intact knee w ith an 89-N anterior force at 30 degrees of knee flexion. Average graf t set force was 68 N, and graft tension in extension was 18 N. In the clinical portion of the study, knee laxity improved from 7.5 to 0.8 mm (side-to-side difference at 89 N). The patients' Lysholm and Tegner s cores improved from 65 to 90 and 3.9 to 5.6, respectively. Only one pa tient had a postoperative contracture. The results of this study sugge st that graft tensioning in full extension provides a low incidence of flexion deformity, maintaining excellent functional results and satis factory biomechanics.