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Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Feb 18, 2016; 7(2): 82-93
Published online Feb 18, 2016. doi: 10.5312/wjo.v7.i2.82
Biomechanics of the anterior cruciate ligament: Physiology, rupture and reconstruction techniques
Christoph Domnick, Michael J Raschke, Mirco Herbort
Christoph Domnick, Michael J Raschke, Mirco Herbort, Department of Trauma, Hand and Reconstructive Surgery, Westphalian Wilhelms University Muenster, 48149 Muenster, Germany
Author contributions: Domnick C, Raschke MJ and Herbort M performed the research and wrote the paper.
Supported by A Research Fellowship from the Faculty of Medicine, Westphalian Wilhelms University Muenster to Domnick C.
Conflict-of-interest statement: There are no conflicts of interest to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Mirco Herbort, MD, Privatdozent, Department of Trauma, Hand and Reconstructive Surgery, Westphalian Wilhelms University Muenster, Waldeyer Strasse 1, 48149 Muenster, Germany. mirco.herbort@uni-muenster.de
Telephone: +49-251-8356301 Fax: +49-251-8356318
Received: June 1, 2015
Peer-review started: June 5, 2015
First decision: August 16, 2015
Revised: September 5, 2015
Accepted: December 1, 2015
Article in press: December 2, 2015
Published online: February 18, 2016
Abstract

The influences and mechanisms of the physiology, rupture and reconstruction of the anterior cruciate ligament (ACL) on kinematics and clinical outcomes have been investigated in many biomechanical and clinical studies over the last several decades. The knee is a complex joint with shifting contact points, pressures and axes that are affected when a ligament is injured. The ACL, as one of the intra-articular ligaments, has a strong influence on the resulting kinematics. Often, other meniscal or ligamentous injuries accompany ACL ruptures and further deteriorate the resulting kinematics and clinical outcomes. Knowing the surgical options, anatomic relations and current evidence to restore ACL function and considering the influence of concomitant injuries on resulting kinematics to restore full function can together help to achieve an optimal outcome.

Keywords: Biomechanics, Anterior cruciate ligament, Joint pressure, Anterior cruciate ligament rupture, Graft fixation, Anterior cruciate ligament reconstruction

Core tip: This review of literature summarizes the influences and mechanisms of the physiology, rupture and reconstruction of the anterior cruciate ligament on kinematics and clinical outcomes. The major focuses are on the resulting joint kinematics after rupture and reconstruction and on biomechanics of graft fixation.