In vitro comparison of over-the-top and through-the-condyle anterior cruciate ligament reconstructions

Knee kinematics, during standard knee examination maneuvers, were measured on 15 fresh cadaveric knees in their normal state and after isolated sectioning of the anterior cruciate ligament using a six degree of freedom electrogoniometer. Proximal iliotibial band autografts were used to perform two anterior cruciate ligament reconstructions on the cadaveric knees: an over-the-top reconstruction and a through-the-condyle procedure. Both of these reconstructions reduced the abnormal anterior translation of the anterior cruciate ligament-deficient knee seen in Lachman testing. However, neither reconstruction restored the normal anterior translation. In addition, other motions remained uncorrected: 1) the internal rotation due to internal torque at full extension; 2) coupled anterior translation during internal rotation at full extension; and 3) coupled medial translation with anterior translation in Lachman testing. There were no statistical differences noted in the joint kinematics created by either reconstruction.