Savio L-Y WOO, Sinan KARAOĞLU, Özgür DEDE

Biyomekaniğin ön çapraz bağ rekonstrüksiyonuna katkıları

Ortopedik cerrahlar ve biyomühendisler, biyomekaniği yıllardır ön çapraz bağın (ÖÇB) karmaşık yapısı hakkında bilgi edinme ve daha iyi bir ÖÇB rekonstrüksiyonu yöntemi geliştirmede kullanmışlardır. Matematik modeller ve robotik test sistemleri gibi yeni yöntemler, çoklu serbestlik derecesinde diz kinematiğini, in situ kuvvetleri ve ÖÇB’nin biyomekanik özelliklerini ölçmede kullanılmıştır. Bu derlemede, örnekler verilerek biyomekaniğin, greft seçimi, tünel yerleşimi, başlangıç greft gerginliği, tespit yöntemleri ve tünel-greft iyileşmesi gibi ÖÇB rekonstrüksiyonunun önemli noktalarının gelişimine nasıl katkıda bulunduğu vurgulanacaktır. Ayrıca, tek bant ÖÇB rekonstrüksiyonundan, daha anatomik olan çift bant ÖÇB rekonstrüksiyonuna geçiş irdelenecektir. Son olarak, gelecekte biyomekaniğin, ÖÇB rekonstrüksiyonunun daha başarılı hale getirilebilmesinde, özellikle in vivo verileri kullanarak, nasıl katkıda bulunabileceği tartışılacaktır.

Anahtar Kelimeler:

Diz eklemi, Biyomekanik, Ön çapraz bağ

Contribution of biomechanics to anterior cruciate ligament reconstruction

For years, bioengineers and orthopedic surgeons have applied the principles of biomechanics to gain valuable information about the complex function of the anterior cruciate ligament (ACL), as well as to improve the design of replacement grafts for ACL reconstruction. New experimental tools, such as robotic testing systems and mathematical models have been used to measure the multiple degree-of-freedom (DOF) knee kinematics, in situ forces, and biomechanical properties of the ACL. This manuscript will review specific examples of how biomechanics has impacted surgical reconstruction of the ACL by improving technical factors such as graft selection, tunnel placement, initial graft tension, graft fixation, and graft tunnel healing. Evolution of the single-bundle ACL reconstruction to the more anatomical double-bundle reconstruction will be featured. Finally, the future role of biomechanics to facilitate in vivo data for further improvement of ACL reconstruction will be discussed.

Keywords:

Knee Joint, Biomechanics, Anterior Cruciate Ligament,

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