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TECHNICAL PAPERS

In Vivo Calibration of a Femoral Fixation Device Transducer for Measuring Anterior Cruciate Ligament Graft Tension: A Study in an Ovine Model

[+] Author and Article Information
Isaac Zacharias, Stephen M. Howell

Department of Mechanical Engineering, University of California, Davis, CA 95616

M. L. Hull

Department of Mechanical Engineering and Biomedical Engineering Program, University of California, Davis, CA 95616

Keith W. Lawhorn

Department of Orthopedics, David Grant Medical Center, Travis Air Force Base, CA 90909

J Biomech Eng 123(4), 355-361 (Feb 27, 2001) (7 pages) doi:10.1115/1.1385842 History: Received March 07, 2000; Revised February 27, 2001
Copyright © 2001 by ASME
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References

Magen,  H. E., Howell,  S. M., and Hull,  M. L., 1999, “Structural Properties of Six Tibial Fixation Methods for Anterior Cruciate Ligament Soft Tissue Grafts,” Am. J. Sports Med., 27, pp. 35–43.
Howell,  S. M., and Hull,  M. L., 1998, “Aggressive Rehabilitation Using Hamstring Tendons: Graft Construct, Tibial Tunnel Placement, Fixation Properties, and Clinical Outcome,” Am. J. Knee Surgery, 11, pp. 120–127.
Halling,  A. H., Howard,  M. E., and Cawley,  P. W., 1993, “Rehabilitation of Anterior Cruciate Ligament Injuries,” Clin. Sports Med., 12, pp. 329–348.
Noyes,  F. R., Mangine,  R. E., and Barber,  S., 1987, “Early Knee Motion After Open and Arthroscopic Anterior Cruciate Ligament Reconstruction,” Am. J. Sports Med., 15, pp. 149–160.
Ventura,  C. P., Wolchok,  J., Hull,  M. L., and Howell,  S. M., 1998, “An Implantable Transducer for Measuring Tension in an Anterior Cruciate Ligament Graft,” ASME J. Biomech. Eng., 120, pp. 327–333.
McKee,  E. L., Lindsey,  D. P., Hull,  M. L., and Howell,  S. M., 1998, “Telemetry System for Monitoring Anterior Cruciate Ligament Graft Forces in Vivo,” Med. Biol. Eng. Comput., 36, pp. 330–336.
Lindsey,  D. P., McKee,  E. L., Hull,  M. L., and Howell,  S. M., 1998, “A New Technique for Transmission of Signals From Implantable Transducers,” IEEE Trans. Biomed. Eng., 45, pp. 614–619.
Rodeo,  S. A., Arnoczky,  S. P., Torzilli,  P. A., Hidaka,  C., and Warren,  R. F., 1993, “Tendon-Healing in a Bone Tunnel. A Biomechanical and Histological Study in the Dog,” J. Bone Jt. Surg., Am. Vol., 75, pp. 1795–1803.
Holden,  J. P., Grood,  E. S., Korvick,  D. L., Cummings,  J. F., Butler,  D. L., and Bylski-Austrow,  D. I., 1994, “In Vivo Forces in the Anterior Cruciate Ligament: Direct Measurements During Walking and Trotting in a Quadruped,” J. Biomech., 27, pp. 517–526.
Frank,  C. B., and Jackson,  D. W., 1997, “The Science of Reconstruction of the Anterior Cruciate Ligament,” J. Bone Jt. Surg., Am. Vol., 79, pp. 1556–1576.
Lundberg,  W. R., Lewis,  J. L., Smith,  J. J., Lindquist,  C., Meglitsch,  T., Lew,  W. D., and Poff,  B. C., 1997, “In Vivo Forces During Remodeling of a Two-Segment Anterior Cruciate Ligament Graft in a Goat Model,” J. Orthop. Res., 15, pp. 645–651.
To, J. T., 1996, “Biomechanical Properties of the Double Loop Hamstring Graft and Three Anterior Cruciate Ligament Graft Fixations,” MS Thesis, Department of Mechanical Engineering, University of California at Davis.
To,  J. T., Howell,  S. M., and Hull,  M. L., 1999, “Contributions of Femoral Fixation Methods to the Stiffness of Anterior Cruciate Ligament Replacements at Implantation,” Arthroscopy, 15, pp. 379–387.
Martin, R. B., and Burr, D. B., 1989, Structure, Function, and Adaptation of Compact Bone, Raven Press, New York.
Markolf,  K. L., Burchfield,  D. M., Shapiro,  M. M., Cha,  C. W., Finerman,  G. A., and Slauterbeck,  J. L., 1996, “Biomechanical Consequences of Replacement of the Anterior Cruciate Ligament With a Patellar Ligament Allograft. Part II: Forces in the Graft Compared With Forces in the Intact Ligament,” J. Bone Jt. Surg., Am. Vol., 78, pp. 1728–1734.
Ding,  M., Dalstra,  M., Danielsen,  C. C., Kabel,  J., Hvid,  I., and Linde,  F., 1997, “Age Variations in the Properties of Human Tibial Trabecular Bone,” J. Bone Joint Surg. Br., 79, pp. 995–1002.
Green,  J. R., Nemzek,  J. A., Arnoczky,  S. P., Johnson,  L. L., and Balas,  M. S., 1999, “The Effect of Bone Compaction on Early Fixation of Porous-Coated Implants,” J. Arthroplasty, 14, pp. 91–97.
Magen, H. E., 1997, “Structural Properties of Six Tibial Fixation Methods for Anterior Cruciate Ligament Soft Tissue Grafts,” MS Thesis, Biomedical Engineering Program, University of California at Davis.

Figures

Grahic Jump Location
Diagram showing the threaded body and hexagonal head welded to the instrumented beam of the FDT. The strain gages were applied to the larger rectangular section and oriented at ±45 deg relative to the long axis of the beam. The threaded body and hexagonal head were hollow to accommodate the three-pronged socket for data transmission.
Grahic Jump Location
Diagram showing the detachment of the common digital extensor tendon from its origin on the lateral femoral condyle
Grahic Jump Location
Diagram showing alignment of the L-shaped wrench to the hollow cylindrical alignment tool. The alignment tool was inserted into the graft tunnel with the cable passing through the center. The L-shaped wrench fit over the hexagonal head of the FDT such that the rod pointed in the direction of the long-axis of the cross section of the FDT beam. When the rod of the L-shaped wrench was parallel to the hollow alignment tool, the FDT was oriented correctly.
Grahic Jump Location
Diagram of the completed FDT surgery. The common digital extensor graft was looped around the post of the FDT and passed back out of the graft tunnel where it was sewn to itself.
Grahic Jump Location
Diagram of the testing setup showing the alignment of the bone tunnel with the axis of the materials testing machine
Grahic Jump Location
Calibration regressions and graft loads for animal S202. The after-graft insertion calibration was nearly identical to the before-graft insertion calibration. The post-mortem calibration matched the before-graft insertion calibration well with a relative percent error of only 4.3 percent using before-graft insertion calibration as the standard. The voltages caused by loading of the graft were very low compared to those in the post-mortem calibration indicating that only a small fraction of the load applied to the graft was actually transmitted to the FDT. The majority of the load was supported by the biological bond between the graft and bone tunnel.

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